Italian Normative Data for the Original Version of the Tower of London Test: A Bivariate Analysis on Speed and Accuracy Scores

Towers of Kuwait Arabic Neurocognitive Assessment: A novel executive and visuospatial functions assessment tool added to the CERAD neuropsychological battery-Arabic version (CERAD-ArNB)

Assessment of executive and visuospatial neurocognitive domains is lacking in the Omani population, especially for elderly individuals with low educational levels. Therefore, the Towers of Kuwait-Arabic Neurocognitive Assessment (ToK-ArNA) was developed using similar psychometric features of Tower of London (ToL) test, and the unique architecture of Towers of Kuwait, with the potential to overcome the limitation of ToL color perception difficulties that might be encountered in subjects with hereditary or acquired color vision disorders. We enrolled 120 older Arabic-speaking Omanis from January 2022 to November 2022 and all participants underwent screening to ensure normal cognitive function before performing the ToL and ToK-ArNA tests. Validity, reliability, and non-parametric statistical tests were used for data analysis. A total of 85 participants, 51 men (60%) and 34 women (40%) met the inclusion criteria and completed the testing. Statistical analyses confirmed the validity and reliability of ToK-ArNA compared to ToL, with comparable total Time and Accuracy scores and more preference towered the ToK-ArNA among the participants. Despite the study limitations, these results indicate that the ToK-ArNA is a reliable and applicable executive and visuospatial function assessment tool and further studies are warranted to establish its validity in patients with various neurocognitive disorders.

Challenging large language models' "intelligence" with human tools: A neuropsychological investigation in Italian language on prefrontal functioning

The Artificial Intelligence (AI) research community has used ad-hoc benchmarks to measure the "intelligence" level of Large Language Models (LLMs). In humans, intelligence is closely linked to the functional integrity of the prefrontal lobes, which are essential for higher-order cognitive processes. Previous research has found that LLMs struggle with cognitive tasks that rely on these prefrontal functions, highlighting a significant challenge in replicating human-like intelligence. In December 2022, OpenAI released ChatGPT, a new chatbot based on the GPT-3.5 model that quickly gained popularity for its impressive ability to understand and respond to human instructions, suggesting a significant step towards intelligent behaviour in AI. Therefore, to rigorously investigate LLMs' level of "intelligence," we evaluated the GPT-3.5 and GPT-4 versions through a neuropsychological assessment using tests in the Italian language routinely employed to assess prefrontal functioning in humans. The same tests were also administered to Claude2 and Llama2 to verify whether similar language models perform similarly in prefrontal tests. When using human performance as a reference, GPT-3.5 showed inhomogeneous results on prefrontal tests, with some tests well above average, others in the lower range, and others frankly impaired. Specifically, we have identified poor planning abilities and difficulty in recognising semantic absurdities and understanding others' intentions and mental states. Claude2 exhibited a similar pattern to GPT-3.5, while Llama2 performed poorly in almost all tests. These inconsistent profiles highlight how LLMs' emergent abilities do not yet mimic human cognitive functioning. The sole exception was GPT-4, which performed within the normative range for all the tasks except planning. Furthermore, we showed how standardised neuropsychological batteries developed to assess human cognitive functions may be suitable for challenging LLMs' performance.

Beyond traditional training: Integrating data from semi-immersive VR dual-task intervention in Parkinsonian Syndromes. A study protocol

Completing cognitive and motor tasks simultaneously requires a high level of cognitive control in terms of executive processes and attentional abilities. Most of the daily activities require a dual-task performance. While walking, for example, it may be necessary to adapt gait to obstacles of the environment or simply participate in a conversation; all these activities involve more than one ability at the same time. This parallel performance may be critical in the cognitive or motor load, especially for patients with neurological diseases such as Parkinsonian Syndromes. Patients are often characterized by a crucial impairment in performing both tasks concurrently, showing a decrease in attention skills and executive functions, thus leading to increased negative outcomes. In this scenario, the accurate assessment of the components involved in dual-task performance is crucial, and providing an early specific training program appears to be essential. The objective of this protocol is to assess cognitive and motor components involved in dual-task performance and create a training program based on ecological activities focusing on executive and motor functions. Thus, we will employ Virtual Reality to provide semi-immersive, multisensory, ecological, standardized, and realistic experiences for rehabilitative purposes in patients with Parkinsonian Syndromes, considering its high prevalence in aging and the incidence of motor and cognitive dysfunctions in this population. Moreover, we propose to integrate the great amount of different data provided by dual-task and Virtual Reality system, using machine learning techniques. These integrations may increase the treatment's reliability in terms of better prognostic indexes and individualized training.

Mental flexibility assessment: A research protocol for patients with Parkinson's Disease and Anorexia Nervosa

Mental Flexibility oscillates between adaptive variability in behavior and the capacity to restore homeostasis, linked to mental health. It has recently been one of the most investigated abilities in mental and neurological diseases such as Anorexia nervosa and Parkinson's disease, studied for rigidity or cognitive inflexibility. Patients with anorexia nervosa have rigid cognitive processes about food and weight, which leads to restrictive eating and excessive exercise. People who struggle to adapt their cognitive processes and actions to change their diet and exercise habits may have a harder time recovering from the disorder. On the other hand, research suggests that Parkinson's disease patients may have cognitive flexibility impairments that impair their ability to perform daily tasks and adapt to new environments. Although of clinical interest, mental flexibility lacks theoretical liberalization and unified assessment. This study introduces "IntellEGO" a protocol for a new, multidimensional psychometric assessment of flexibility. This assessment evaluates a person's authentic ability to handle daily challenges using cognitive, emotional, and behavioral factors. Since traditional assessments often focus on one domain, we aim to examine flexibility from multiple angles, acknowledging the importance of viewing people as whole beings with mental and physical aspects. The study protocol includes two assessment phases separated by a rehabilitation period. T0, the acute phase upon admission, and T1, the post-rehabilitation phase lasting 15 days for Parkinson's patients and 4 weeks for eating disorder patients, will be assessed. Neuropsychological performance, self-report questionnaires, psychophysiological measures, and neuroendocrine measures will be collected from Anorexia Nervosa and Parkinson's Disease patients during each study phase. The objective of this procedure is to provide clinicians with a comprehensive framework for conducting meticulous assessments of mental flexibility. This framework considers emotional, cognitive, and behavioral factors, and is applicable to various patient populations.

Normative data for the Tower of London (Drexel version) in the Quebec-French population aged between 50 and 88 years

The Tower of London (ToL) is a neuropsychological test used to assess several executive functions such as strategical reasoning, mental planning, and problem-solving. Like other cognitive tests, performance on the ToL can vary according to age, level of education, sex, and cultural background of individuals. The present study aimed to establish normative data for the Drexel version of the ToL among French-Quebec people aged 50 years and over. The normative sample consisted of 174 healthy individuals aged 50-88 years, all from the province of Quebec, Canada. Analyses were performed to estimate the associations between age, sex, and education level on one hand, and ToL performance, on the other hand. Results indicated that Total Execution Time was associated with age, whereas the Total Type II Errors and Total Rule Violation score (Type I + II Errors) were associated with both age and education level. All other scores were not significantly associated with the demographic characteristics of the participants. Since the distributions of the data were all skewed, the normative data are presented in the form of percentile ranks. To conclude, the present norms will ease the detection of executive impairments in French-Quebec middle-aged and older adults.

Short-Term Benefits of Continuous Positive Airway Pressure Treatment on Cognition in the Obstructive Sleep Apnea Syndrome: A Retrospective Study

The Obstructive Sleep Apnea Syndrome (OSAS) significantly impacts cognitive functioning. The prolonged use (more than 3 months) of ventilotherapy with continuous positive airway pressure (CPAP) seems to have positive effects in restoring cognitive difficulties. However, there is poor evidence about its possible short-term effect. We investigated whether the short use (less than 15 days at testing) of CPAP improved the cognitive functioning in fifty individuals with OSAS by collecting retrospective neuropsychological measures about verbal memory and learning, information processing speed, attention (i.e., alerting, orienting, and executive system), and executive functions (i.e., strategic reasoning, problem-solving, and mental planning). The predictive role of days of CPAP use on the neuropsychological scores was assessed by hierarchical multiple linear regression analyses, over and above the possible role of demographics, body mass index, level of OSAS severity, and the level of anxiety and depression. The average number of days since CPAP adaptation was 4.70 (SD = 3.90; range = 0-15). As the days of CPAP adaptation increased, verbal learning and long-term memory significantly improved, contrary to the other assessed domains. Our results show a significant improvement in some cognitive functions even after a short treatment with CPAP, pointing to the importance of the early use of ventilotherapy to rapidly improve cognitive functioning. Identifying which cognitive functions can or cannot be restored with CPAP use may enable the design of complementary neuropsychological interventions focused on those residual difficulties, possibly enhancing patients' compliance to the treatment.