Pain Management through Neurocognitive Therapeutic Exercises in Hypermobile Ehlers–Danlos Syndrome Patients with Chronic Low Back Pain

Background. The hypermobile type of Ehlers–Danlos syndrome (hEDS) is likely the most common hereditary disorder of connective tissue mainly characterized by joint hypermobility. Patients with hEDS suffer joint pain, in particular low back pain, commonly resistant to drug therapy. The aim of this research was to evaluate a neurocognitive rehabilitation approach based not only on the motion and function recovery but also on the pain management. Methods. In this nonrandomized clinical trial, eighteen hEDS patients (4 males and 14 females) with mean age 21 years (range 13-55) were recruited and evaluated before and after three months of rehabilitation treatment. Results. The outcome scores showed significant statistical results after treatment in reducing pain symptoms (numerical rating scale, P = 0.003 ; McGill (total score), P = 0.03 ), fatigue (fatigue severity scale, P = 0.03 ), fear of movement (Tampa scale, P = 0.003 ), and pain-associated disability (Oswestry disability index, P = 0.03 ). Conclusion. The clinical results observed in our study seem to confirm the role of a specific neurocognitive rehabilitation program in the chronic pain management in the Ehlers–Danlos syndrome; the rehabilitation treatment should be tailored on patient problems and focused not only in the recovery of movement but also on pain perception.

Neurocognitive Empowerment for Addiction Treatment (NEAT): study protocol for a randomized controlled trial

Background Neurocognitive deficits (NCDs) and associated meta-cognition difficulties associated with chronic substance use often delay the learning and change process necessary for addiction recovery and relapse prevention. However, very few cognitive remediation programs have been developed to target NCDs and meta-cognition for substance users. The study described herein aims to investigate the efficacy of a multi-component neurocognitive rehabilitation and awareness program termed “Neurocognitive Empowerment for Addiction Treatment” (NEAT). NEAT is a fully manualized, cartoon-based intervention involving psychoeducation, cognitive practice, and compensatory strategies relevant across 10 major cognitive domains, including aspects of attention, memory, executive functions, and decision-making. Method/design In a single-blind randomized controlled trial (RCT), 80 female opioid and/or methamphetamine users will be recruited from an addiction recovery program providing an alternative to incarceration for women with substance use-related offenses. Eight groups of 9–12 participants will be randomized into NEAT or treatment-as-usual (TAU). NEAT involves 14 90-min sessions, delivered twice weekly. The primary outcome is change in self-reported drug craving from before to after intervention using Obsessive Compulsive Drug Use Scale. Secondary and exploratory outcomes include additional psychological, neurocognitive, and structural and functional neuroimaging measures. Clinical measures will be performed at five time points (pre- and post-intervention, 3-, 6-, and 12-month follow-up); neuroimaging measures will be completed at pre- and post-intervention. Discussion The present RCT is the first study to examine the efficacy of an adjunctive neurocognitive rehabilitation and awareness program for addiction. Results from this study will provide initial information concerning potential clinical efficacy of the treatment, as well as delineate neural mechanisms potentially targeted by this novel intervention. Trial registration ClinicalTrials.govNCT03922646. Registered on 22 April 2019

Modern Foreign Neurocognitive Approaches to the use of the Music-Enriched Environment in the Rehabilitation of Aphasic Disorders and Alzheimer's type Dementia

This paper presents an analysis of current foreign trends in neurocognitive rehabilitation of cognitive disorders in Alzheimer's dementia (AD) and neuropsychological rehabilitation of the most common form of vascular cognitive disorders (VCD) - aphasia. Two approaches to the restoration of higher mental functions (HMF), based on a different understanding of the neuroplasticity mechanisms, are described. The description presents non-invasive and functional methods of direct stimulation of HMF. Various methods of transcranial brain stimulation and Intensive Language-Action Therapy (ILAT) are reviewed and analyzed. The data of experimental studies present the application of these methods to the restoration of Broca's aphasia. The paper also considers an approach to neurorehabilitation based on the methodology of "workaround" recovery of HMF using sensory-enriched environment. The article describes and analyzes the theoretical foundations of Music Intonation Therapy (MIT), Thérapie mélodique est rythmée) (TMR), palliative MIT, Music Therapy (MT). The paper carries out an analytical review of the implementation of abovementioned methods in aphasics. Also, programs and neurocognitive correction methods in mild cognitive impairment (MCI) are considered. The paper describes the possibilities of using active and passive MT, STAM-DEM Therapy, and Multimodal Cognitive Enhancement Therapy (MCET) in AD. The study presents the data of systematic and meta-analytical reviews on their use in MCI. The paper describes the methodology of "musical" neuropsychological diagnostics in dementia.

The Role of Gamification in Neurocognitive Rehabilitation

Neurocognitive rehabilitation continues to face difficult challenges related to patient and institutional characteristics. This reality requires innovative solutions to increase patient motivation and involvement in the process, turning rehabilitation more meaningful and pleasurable, as well as to help therapists overcome difficulties such as the absence of material and human resources. Innovative rehabilitation techniques have the potential to create motivating, personalized, and ecologically valid tasks. In this chapter, the authors describe the reality of neurocognitive rehabilitation in acquired brain injury and present the advantages and potential of digital information and communication technologies, especially serious games and gamification. Distinctive elements of these solutions and a reflection on the evolution of this area are presented. In order to establish evidence-based practices, it will be necessary demonstrate unequivocally the development of competences by the patients, supported by these new solutions, and its generalization to real-life activities in future research.