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Maggio MG, Luca A, Calabrò RS, Drago F, Nicoletti A. Can mobile health apps with smartphones and tablets be the new frontier of cognitive rehabilitation in older individuals? A narrative review of a growing field. Neurol Sci 2024; 45:37-45. [PMID: 37702829 PMCID: PMC10761459 DOI: 10.1007/s10072-023-07045-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/26/2023] [Indexed: 09/14/2023]
Abstract
INTRODUCTION A recent interesting field of application of telemedicine/e-health involved smartphone apps. Although research on mHealth began in 2014, there are still few studies using these technologies in healthy elderly and in neurodegenerative disorders. Thus, the aim of the present review was to summarize current evidence on the usability and effectiveness of the use of mHealth in older adults and patients with neurodegenerative disorders. METHODS This review was conducted by searching for recent peer-reviewed articles published between June 1, 2010 and March 2023 using the following databases: Pubmed, Embase, Cochrane Database, and Web of Science. After duplicate removal, abstract and title screening, 25 articles were included in the full-text assessment. RESULTS Ten articles assessed the acceptance and usability, and 15 articles evaluated the efficacy of e-health in both older individuals and patients with neurodegenerative disorders. The majority of studies reported that mHealth training was well accepted by the users, and was able to stimulate cognitive abilities, such as processing speed, prospective and episodic memory, and executive functioning, making smartphones and tablets valuable tools to enhance cognitive performances. However, the studies are mainly case series, case-control, and in general small-scale studies and often without follow-up, and only a few RCTs have been published to date. CONCLUSIONS Despite the great attention paid to mHealth in recent years, the evidence in the literature on their effectiveness is scarce and not comparable. Longitudinal RCTs are needed to evaluate the efficacy of mHealth cognitive rehabilitation in the elderly and in patients with neurodegenerative disorders.
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Affiliation(s)
- Maria Grazia Maggio
- Department of Biomedical and Biotechnological Sciences, Biological Tower, School of Medicine, University of Catania, Via S. Sofia 97, 95123, Catania, Italy
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Antonina Luca
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | | | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, Biological Tower, School of Medicine, University of Catania, Via S. Sofia 97, 95123, Catania, Italy
| | - Alessandra Nicoletti
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy.
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Annese J, Klaming R, Haase Alasantro L, Feinstein JS. A case of severe anterograde amnesia in the era of smartphone technology. J Clin Exp Neuropsychol 2023; 45:498-512. [PMID: 37916950 DOI: 10.1080/13803395.2023.2254911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/29/2023] [Indexed: 11/03/2023]
Abstract
A.V. is a young herpes simplex encephalitis (HSE) survivor who suffered extensive bilateral damage to the medial temporal lobe (MTL) leading to a severe and pervasive form of anterograde amnesia. Structural Magnetic Resonance Imaging (MRI) revealed lesions that encompass the hippocampus and amygdala in both hemispheres and that extend more laterally in the right temporal lobe. At the same time, detailed neuropsychological testing showed that the disparity between A.V.'s preserved intellectual functioning (Full Scale IQ: 115) and severe memory deficit (Delayed Memory Index: 42) is one of the largest on record. Despite this deficit, A.V. has regained a higher level of functioning and autonomy compared to previously documented amnesic cases with major bilateral MTL lesions. As a millennial, one advantage which A.V. has over prior amnesic cases is fluency with digital technology - particularly the smartphone. The analysis of his phone and specific app usage showed a pattern that is consistent with the strategy to offload cognitive tasks that would normally be supported by the MTL. A.V.'s behavior is significant in terms of rehabilitation and may have broader implications at the societal level and for public health given the ubiquity of smartphone technology and its potential to become integrated with neural mnemonic functions.
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Affiliation(s)
| | - Ruth Klaming
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- Vrije Universiteit Amsterdam Medical Center, Amsterdam, The Netherlands
| | - Lori Haase Alasantro
- Department of Psychiatry, University of California, San Diego, CA, USA
- The Neurology Center of Southern California, Carlsbad, CA, USA
| | - Justin S Feinstein
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Department of Neurology, University of Iowa, Iowa City, IA, USA
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Shimizu D, Miyahara T, Tanemura R. Community-based practical behavioral intervention in public transportation for people with acquired brain injury: study of two cases using a single-case experimental design study. Neurocase 2022; 28:302-309. [PMID: 35914121 DOI: 10.1080/13554794.2022.2106876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The purpose of this paper was to report on the progress of a behavioral approach to enable patients with acquired brain injury (age 57, male, stroke and age 36, old, female, TBI) using a community activity support center to commute alone using public transportation. In this study, two ABI patients were intervened to enable them to use public transportation. The frequency of intervention was once a month or once a week. The two community-dwelling adults each had post-ABI attention and memory deficits and anxiety. A-B-A single-case experimental design was employed for this study. The transportation route was stepped into multiple steps. Each step was scored in a unique way to determine the degree of assistance the participant received from others. This score was considered the main outcome. Tau-U analysis was used for statistical analysis. Statistically significant improvements in public transportation use were shown between baseline and intervention. There were no significant differences between the intervention and follow-up periods. The results suggest that behavioral interventions are beneficial in reacquiring the ability to use public transportation and that the intervention effects are sustained.
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Affiliation(s)
- Daisuke Shimizu
- Department of Occupational Therapy, School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Japan
| | | | - Rumi Tanemura
- Department of Rehabilitation Science, Kobe University, Graduate School of Health Sciences, Kobe, Japan
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Wilson SA, Byrne P, Rodgers SE, Maden M. A Systematic review of smartphone and tablet use by older adults with and without cognitive impairment. Innov Aging 2022; 6:igac002. [PMID: 35243008 PMCID: PMC8889997 DOI: 10.1093/geroni/igac002] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Indexed: 12/04/2022] Open
Abstract
Background and Objectives A systematic review was conducted to explore the use of smartphones and tablet computers as cognitive and memory aids by older adults with and without cognitive impairment, specifically the effects of smartphone and tablet use on participants’ cognition and memory, and the barriers and facilitators to smartphone and tablet use for cognitive and memory support. Research Design and Methods A systematic search of 6 key databases found 11,895 citations published between 2010 and 2021. Studies were included if they involved community-dwelling older adults with or without cognitive impairment arising from acquired brain injury, mild cognitive impairment, or dementia, and if they evaluated everyday smartphone or tablet device use for cognition, memory, or activities of daily living. Results A total of 28 papers were included in the narrative synthesis. There was some evidence that the use of smartphones and tablets could aid cognitive function in older adults without cognitive impairment, particularly executive function and processing speed. There was modest evidence that smartphone and tablet use could support memory in both older adults without cognitive impairment and those with acquired brain injury and dementia. Discussion and Implications Smartphones and tablets were seen by users as acceptable, enjoyable, and nonstigmatizing alternatives to conventional assistive technology devices; however, current use of smartphone and tablet devices is hindered by the digital literacy of older adults, a lack of accommodation for older adult users’ motor and sensory impairments, and a lack of input from clinicians and researchers. Much of the evidence presented in this review derives from case studies and small-scale trials of smartphone and tablet training interventions. Further research is needed into older adults’ use of smartphones and tablets for cognitive support before and after the onset of cognitive impairment in order to develop effective evidence-based smart technology cognition and memory aids.
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Affiliation(s)
- Samantha A Wilson
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Paula Byrne
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Sarah E Rodgers
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
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Burles F, Iaria G. Behavioural and cognitive mechanisms of Developmental Topographical Disorientation. Sci Rep 2020; 10:20932. [PMID: 33262419 PMCID: PMC7708628 DOI: 10.1038/s41598-020-77759-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/13/2020] [Indexed: 11/17/2022] Open
Abstract
Individuals affected by Developmental Topographical Disorientation (DTD) get lost on a daily basis, even in the most familiar of surroundings such as their neighbourhood, the building where they have worked for many years, and, in extreme cases, even in their own homes. Individuals with DTD report a lifelong selective inability to orient despite otherwise well-preserved general cognitive functions, and the absence of any acquired brain injury or neurological condition, with general intelligence reported to be within the normal range. To date, the mechanisms underlying such a selective developmental condition remain unknown. Here, we report the findings of a 10-year-long study investigating the behavioural and cognitive mechanisms of DTD in a large sample of 1211 cases. We describe the demographics, heritability pattern, self-reported and objective spatial abilities, and some personality traits of individuals with DTD as compared to a sample of 1624 healthy controls; importantly, we test the specific hypothesis that the presence of DTD is significantly related to the inability of the individuals to form a mental representation of the spatial surroundings (i.e., a cognitive map). We found that individuals with DTD reported relatively greater levels of neuroticism and negative affect, and rated themselves more poorly on self-report measures of memory and imagery skills related to objects, faces, and places. While performing interactive tasks, as a group, the individuals with DTD performed slightly worse on a scene-based perspective-taking task, and, notably struggled to solve tasks that demand the generation and use of a cognitive map. These novel findings help define the phenotype of DTD, and lay the foundation for future studies of the neurological and genetic mechanisms of this lifelong condition.
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Affiliation(s)
- Ford Burles
- NeuroLab, Department of Psychology, University of Calgary, Calgary, AB, Canada.
| | - Giuseppe Iaria
- NeuroLab, Department of Psychology, University of Calgary, Calgary, AB, Canada.
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Robin J, Rivest J, Rosenbaum RS, Moscovitch M. Remote spatial and autobiographical memory in cases of episodic amnesia and topographical disorientation. Cortex 2019; 119:237-257. [DOI: 10.1016/j.cortex.2019.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/24/2019] [Accepted: 04/23/2019] [Indexed: 12/11/2022]
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Boccia M, Bonavita A, Diana S, Di Vita A, Ciurli MP, Guariglia C. Topographical Disorientation: Clinical and Theoretical Significance of Long-Lasting Improvements Following Imagery-Based Training. Front Hum Neurosci 2019; 13:322. [PMID: 31616267 PMCID: PMC6764239 DOI: 10.3389/fnhum.2019.00322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 09/02/2019] [Indexed: 12/23/2022] Open
Abstract
Neuropsychological studies on acquired topographical disorientation have provided useful insights into the contribution of different brain regions to human navigation. However, little is known about the possibility to restore navigational skills after brain damage. Here we describe the case of No Longer Lost (NLL), a 49-year-old man who complained of severe topographical disorientation following traumatic brain injury. Extensive neuropsychological evaluation at baseline revealed selective episodic memory deficits and topographical disorientation. NLL underwent 8-week imagery-based treatment (IBT) inspired by current cognitive models of human spatial navigation. After IBT, NLL improved topographical skills and episodic memory. From a clinical point of view, the present study describes a model-based intervention for topographical disorientation. From a theoretical point of view, it provides new insights into the cognitive models of human spatial navigation and straightforward evidence about common phylogenetic roots of brain mechanisms devoted to spatial navigation and memory.
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Affiliation(s)
- Maddalena Boccia
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Alessia Bonavita
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Sofia Diana
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, "Sapienza" University of Rome, Rome, Italy.,Department of Human Neuroscience, "Sapienza" University of Rome, Rome, Italy
| | - Antonella Di Vita
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Human Neuroscience, "Sapienza" University of Rome, Rome, Italy
| | | | - Cecilia Guariglia
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, "Sapienza" University of Rome, Rome, Italy
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Irving S, Pradhan C, Dieterich M, Brandt T, Zwergal A, Schöberl F. Transient topographical disorientation due to right-sided hippocampal hemorrhage. Brain Behav 2018; 8:e01078. [PMID: 30141244 PMCID: PMC6160660 DOI: 10.1002/brb3.1078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 06/15/2018] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Topographical disorientation is defined as the inability to recognize familiar or unfamiliar environments. While its slowly progressive development is a common feature of neurodegenerative processes like Alzheimer's dementia, acute presentations are less frequent and mostly caused by strategic lesions within the cerebral navigation network. Depending on the lesion site, topographical disorientation can originate from deficits in landmark recognition and utilization for route planning (egocentric navigation deficit), or disturbance of an overarching cognitive map of the spatial environment (allocentric navigation deficit). However, objective measurements of spatial navigation performance over time are largely missing in patients with topographical disorientation. METHODS We here report a 55-year-old patient with acute topographical disorientation as the single symptom of right-sided hippocampal hemorrhage and present quantitative gaze-monitoring head camera-based analyses of his path-finding strategy and visual exploration behavior in a real space navigation paradigm. RESULTS The patient exhibited severe allocentric and also egocentric navigation deficits during the acute phase, shown by higher error rates at finding target items. In addition, he showed a more extensive use of search saccades toward, and fixations on, landmarks that could potentially serve as spatial cues. These deficits had been completely compensated for after four months, when the patient performed unremarkably in the real space navigation task, and used even more strongly allocentric path optimization strategies than age-matched controls. CONCLUSIONS This case report highlights the integral function and right-sided dominance of the hippocampal formation in the cerebral navigation network in humans. It shows that the cognitive map can be restored completely despite a residual hippocampal lesion, which illustrates the enormous plasticity of the cerebral navigation network in humans.
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Affiliation(s)
- Stephanie Irving
- German Center for Vertigo and Balance Disorders, DSGZ, Ludwig-Maximilians-University, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-University, Munich, Germany
| | - Cauchy Pradhan
- German Center for Vertigo and Balance Disorders, DSGZ, Ludwig-Maximilians-University, Munich, Germany
| | - Marianne Dieterich
- German Center for Vertigo and Balance Disorders, DSGZ, Ludwig-Maximilians-University, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-University, Munich, Germany.,Department of Neurology, Ludwig-Maximilians-University, Munich, Germany.,Munich Cluster of Systems Neurology, SyNergy, Munich, Germany
| | - Thomas Brandt
- German Center for Vertigo and Balance Disorders, DSGZ, Ludwig-Maximilians-University, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-University, Munich, Germany.,Clinical Neurosciences, Ludwig-Maximilians-University, Munich, Germany
| | - Andreas Zwergal
- German Center for Vertigo and Balance Disorders, DSGZ, Ludwig-Maximilians-University, Munich, Germany.,Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | - Florian Schöberl
- German Center for Vertigo and Balance Disorders, DSGZ, Ludwig-Maximilians-University, Munich, Germany.,Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
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Bier N, Sablier J, Briand C, Pinard S, Rialle V, Giroux S, Pigot H, Quillion Dupré L, Bauchet J, Monfort E, Bosshardt E, Courbet L. Special issue on technology and neuropsychological rehabilitation: Overview and reflections on ways to conduct future studies and support clinical practice. Neuropsychol Rehabil 2018; 28:864-877. [PMID: 29544391 DOI: 10.1080/09602011.2018.1437677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In this editorial, we wish to highlight and reflect on research advances presented in the articles comprising this special issue on technology and neuropsychological rehabilitation, which happens to be published more than a decade after the first special issue on the subject. In 2004, the journal recognised the great potential of information technology for increasing the support provided to people with cognitive deficits, and published emerging state-of-the art practices in the field. Since that time, research and technology have made tremendous progress, and the influence of information technology on research methods has transformed the field of neurorehabilitation. The aim of this editorial is thus to shed light on methodological and conceptual issues requiring further attention from researchers and clinicians in the fields of neuropsychological rehabilitation and technology, and to stimulate debate on promising avenues in clinical research.
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Affiliation(s)
- Nathalie Bier
- a Faculty of Medecine, École de réadaptation, Université de Montréal , Montréal , Canada.,b Centre de recherche de l'Institut universitaire de gériatrie de Montréal , Montréal , Canada
| | - Juliette Sablier
- c Institut des Sciences et Techniques de la Réadaptation , Lyons , France
| | - Catherine Briand
- a Faculty of Medecine, École de réadaptation, Université de Montréal , Montréal , Canada.,d Centre de recherche de l'Institut universitaire en santé mentale de Montréal , Montréal , Canada
| | - Stéphanie Pinard
- a Faculty of Medecine, École de réadaptation, Université de Montréal , Montréal , Canada
| | - Vincent Rialle
- e CHU Grenoble Alpes, Université Grenoble Alpes , Grenoble , France
| | - Sylvain Giroux
- f Université de Sherbrooke, Laboratoire DOMUS , Sherbrooke , Canada
| | - Hélène Pigot
- f Université de Sherbrooke, Laboratoire DOMUS , Sherbrooke , Canada
| | | | | | | | - Esther Bosshardt
- e CHU Grenoble Alpes, Université Grenoble Alpes , Grenoble , France
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Robin J, Lowe MX, Pishdadian S, Rivest J, Cant JS, Moscovitch M. Selective scene perception deficits in a case of topographical disorientation. Cortex 2017; 92:70-80. [DOI: 10.1016/j.cortex.2017.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 11/22/2016] [Accepted: 03/20/2017] [Indexed: 11/28/2022]
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