Background: Post-stroke pain (PSP), particularly shoulder pain, is frequent and often underdiagnosed, limiting rehabilitation adherence and functional recovery. Current pharmacological and physical treatments offer only partial relief. Robotic-assisted therapy (RAT), such as the gravity-supporting Armeo® Spring exoskeleton, delivers intensive, task-specific training with visual 2D feedback that may also alleviate PSP while enhancing motor outcomes. This study investigates whether RAT performed with the Armeo® Spring reduces upper-limb PSP in chronic stroke patients versus conventional therapy and evaluates its effects on motor function and functional independence. Methods: In this retrospective parallel group study, 32 chronic post-stroke patients (8 females and 24 males with a mean age of 57 ± 11.74) were allocated to two groups: 16 received upper-limb RAT with the Armeo® Spring, a gravity-supporting exoskeleton, (RAT group) and 16 underwent conventional rehabilitation (CR). The RAT group completed one-hour sessions 6 days/week for 8 weeks, performing 2D/3D gamified tasks targeting shoulder, elbow and forearm movements. The CR group received an equivalent amount of standard therapy, including passive/active-assisted mobilization, Bobath-based neuromuscular facilitation and reaching exercises. Results: Both the Armeo® Spring and conventional therapy groups showed significant reductions in post-stroke pain (RAT p < 0.001 and conventional rehabilitation p = 0.004) and improvements in upper-limb motor function and functional independence (both p ≤ 0.002). Spasticity in the impaired limb decreased modestly in the RAT group (p = 0.031), with no significant between-group differences in pain or spasticity change (p = 0.437; p > 0.05, respectively). Conclusions: Gravity-support exoskeleton training reduced upper-limb spasticity, and no statistically significant between-group differences were observed compared with conventional physiotherapy for pain, mobility, and functional independence. Although clinical outcomes improved, health-related quality-of-life domains showed heterogeneous trajectories, underscoring the complexity of perceived health changes during chronic stroke rehabilitation. Larger randomized controlled trials incorporating neurophysiological and kinematic endpoints and longer follow-up are warranted to confirm effectiveness, particularly in chronic stroke and durability.

BACKGROUND:Cognitive impairment is a common non-motor symptom in Multiple Sclerosis (MS), negatively affecting autonomy and Quality of Life (QoL). Innovative rehabilitation strategies, such as semi-immersive virtual reality (VR) and computerized cognitive training (CCT), may offer advantages over traditional cognitive rehabilitation (TCR), particularly in terms of engagement, specificity, adaptability, and ecological validity. This study aimed to compare the efficacy of semi-immersive VR, CCT using the ERICA platform, and TCR on cognitive outcomes and depressive/anxiety symptoms in individuals with MS. METHODS:Eighty-seven patients with MS and mild to moderate cognitive impairment were randomly assigned to three groups: VR-based training, CCT, or TCR. Each group underwent 24 individual sessions delivered regularly three times per week over 8 weeks. Neuropsychological assessments were conducted at baseline (T0) and post-intervention (T1), evaluating information processing speed (SDMT), memory (SRT, SPART), executive functions (WLG), emotional status (BDI, HRS-A), and QoL (MSQOL-54). RESULTS:All groups showed significant improvements in most cognitive and depressive (BDI)/anxiety symptoms (HRS-A) after the intervention. However, the VR group demonstrated significantly greater gains in executive functions, working memory, and QoL (MSQOL-54 Physical and Mental Composite scores) compared to both the CCT and TCR groups (p < 0.001). While the CCT group showed selective improvements in mood and working memory, its overall efficacy did not significantly differ from that of TCR. CONCLUSIONS:Semi-immersive VR represents an effective and engaging approach to cognitive rehabilitation in MS, likely due to its capacity to deliver multisensory, adaptive, and ecologically valid stimulation. Nonetheless, a tailored hybrid model integrating VR with conventional and computer-based strategies may further optimize outcomes and support functional independence in individuals with MS.

Background: Pelvic floor dysfunction (PFD) is frequent in neurological disorders, but it is often approached as a secondary urological or gynecological problem rather than a functional rehabilitation target. Neurological disease can disturb cortical, pontine, spinal, sacral, autonomic, somatic, and sensory pathways that regulate bladder storage, voiding, bowel evacuation, sexual function, and pelvic pain modulation. Methods: This narrative review synthesized biomedical evidence identified through PubMed searches from database inception to 2 May 2026. Search concepts included neurogenic lower urinary tract dysfunction, urinary and bowel dysfunction, sexual dysfunction, pelvic pain, pelvic floor rehabilitation, biofeedback, electrical stimulation, neuromodulation, telerehabilitation, robotics, and major neurological disorders. The review was oriented according to the Scale for the Assessment of Narrative Review Articles (SANRA) and was not designed as a systematic review or meta-analysis. Results: Evidence from multiple sclerosis, stroke, Parkinson’s disease, Alzheimer’s disease and related dementias, spinal cord injury, and fibromyalgia or nociplastic pain syndromes supports a phenotype-based framework in which pelvic floor muscle training, bladder and bowel training, biofeedback, neuromuscular electrical stimulation, posterior tibial nerve stimulation, sacral neuromodulation, telerehabilitation, robotics, and multidisciplinary care are considered complementary rather than interchangeable strategies. Conclusions: PFD in neurological disorders may be more appropriately conceptualized as a multidimensional neurorehabilitation target. Effective care depends on disease-informed phenotyping, individualized rehabilitation goals, attention to cognition and adherence, and standardized outcome measurement. Future studies should test phenotype-specific pathways that integrate bladder, bowel, sexual, pain, participation, safety, and caregiver outcomes.

BACKGROUND:Substance use disorders (SUDs) are a major global health burden, and third-wave therapies that target transdiagnostic processes such as psychological flexibility and mindfulness have emerged as promising options. This systematic review synthesized evidence on third-wave interventions for adults with diagnostic and statistical manual of mental disorder (DSM)-defined SUDs. METHODS:A comprehensive search of seven databases (2014-2025) identified randomized and non-randomized studies of acceptance and commitment therapy (ACT), related mindfulness-based programs, and dialectical behavioral therapy skills training. Two reviewers screened records, extracted data, assessed risk of bias with Risk of Bias 2 (RoB 2) and risk of bias in non-randomized studies of interventions (ROBINS-I), and synthesized findings using SWiM-consistent narrative methods. The review was prospectively registered in PROSPERO (CRD420251028610). RESULTS:Forty-seven studies (35 randomized, 12 non-randomized) met inclusion criteria. Across modalities, third-wave interventions yielded small-to-moderate benefits on abstinence, craving, and substance use outcomes compared with control conditions, with larger and more consistent gains in psychological flexibility, emotion regulation, and mindfulness. Effect sizes varied and most trials showed some concerns or serious risk of bias, resulting in generally low-to-moderate certainty of evidence. CONCLUSIONS:Third-wave interventions may serve as adjunctive or alternative SUD treatments by engaging targeted mechanisms, enhancing psychological functioning, and producing modest but clinically relevant substance-use benefits. More rigorous, adequately powered mechanism-focused trials are needed to clarify comparative efficacy and guide process-based personalization and implementation in routine addiction services.

ABSTRACT Background and Aims Self‐compassion is a supportive self‐relating style linked to emotional well‐being. Acceptance and Commitment Therapy (ACT) targets psychological flexibility and may influence self‐compassion, yet evidence is inconsistently quantified. This systematic review investigated changes in self‐compassion following ACT or ACT‐based interventions in adults with mental health concerns and summarized findings for self‐criticism and emotional well‐being. Methods We followed PRISMA 2020 and preregistered the protocol on the Open Science Framework (10.17605/OSF.IO/8u7e9). PubMed, Embase, Web of Science, and the Cochrane Library were searched to August 5, 2024. Two reviewers (A.C., D.L.) independently screened studies and extracted data. C.F. adjudicated discrepancies, with substantial agreement at title and abstract screening (κ = 0.72) and full‐text eligibility (κ = 0.78). RoB 2 and ROBINS‐I were used for randomized and non‐randomized studies. We synthesized results narratively following SWiM and reported effect estimates with uncertainty when available. Meta‐analysis was not performed. Results Ten studies were included (five randomized controlled trials and five non‐randomized, experimental, or qualitative studies). Self‐compassion was most often measured with the self‐compassion scale. In trials, within‐group improvements were common, but between‐group effects were mixed, ranging from negligible contrasts to large gains in selected samples (one trial reported a large within‐group change, d ≈ 1.5, versus a smaller change in the waitlist). A pre–post chronic pain evaluation reported a small improvement in self‐compassion (d ≈ 0.21). Self‐criticism was reported in one trial with minimal post‐treatment separation, and emotional well‐being outcomes were variably defined and mixed. Most randomized controlled trials had some concerns of bias (one high risk), and most non‐randomized studies were at serious risk or provided insufficient information. Conclusion ACT may improve self‐compassion, but comparative effects are inconsistent and certainty is limited. Standardized measurement and complete reporting are needed to clarify durability and clinical relevance.

BackgroundFreezing of Gait (FoG) is a debilitating motor symptom affecting nearly half of individuals with Parkinson's disease (PD), increasing fall risk and reducing independence. Despite pharmacological and neuromodulation therapies, residual symptoms often persist, underscoring the need for complementary rehabilitation strategies.ObjectiveTo evaluate the effects of body weight-supported treadmill training using differential air pressure on gait and mobility in PD patients.MethodsForty patients with idiopathic PD were randomly assigned to an experimental group (EG, n = 20), who received gait training with a lower-body positive pressure treadmill, or to a control group (CG, n = 20), who underwent conventional physiotherapy. Both groups trained twice weekly for 4 months. Outcomes were assessed at baseline (T0) and post-intervention (T1), and classified as primary (gait speed, step length, balance, postural stability) or secondary (quality of life, fear of falling, anxiety).ResultsCompared to controls, the EG showed significant improvements in gait speed, step length, balance, and postural stability (all p < 0.01). Secondary outcomes also improved, with reductions in fear of falling (p < 0.01) and better quality of life scores (p < 0.01).ConclusionsThis pilot trial suggests that body weight-supported treadmill training through differential air pressure may improve gait performance and postural control, while also enhancing quality of life in PD patients with mobility impairments and FoG. These preliminary findings support its potential role as a complementary rehabilitation strategy, warranting confirmation in larger trials.

Background and Objectives: Sexual dysfunction (SD) is common in multiple sclerosis (MS) but remains under-recognized in routine care. This study aimed to quantify the burden of SD in men and women with relapsing–remitting MS (RRMS), describe sex-stratified patterns across primary/secondary/tertiary domains, and examine associations with fatigue and MS-related health-related quality of life (HRQoL). Materials and Methods: In this cross-sectional observational study, RRMS participants were voluntarily recruited online via a QR code linking to a Google Forms survey. Men completed the International Index of Erectile Function-5 (IIEF-5), and women the Female Sexual Function Index (FSFI). MS-specific SD domains were assessed using the Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ), alongside the Fatigue Severity Scale (FSS) and the Multiple Sclerosis Quality of Life questionnaire (MSQOL-54). Sex differences were tested using parametric/non-parametric methods as appropriate, with false discovery rate (FDR) and Bonferroni adjustments for multiple comparisons. Results: Thirty-seven participants were included (16 men; 21 women). Mean age did not differ by sex (35.9 ± 4.0 vs. 38.9 ± 10.4 years; p = 0.23). All participants reported at least some degree of difficulty across MSISQ domains. Among men, 87.5% screened positive for erectile dysfunction within this sample (mild 37.5%, mild-to-moderate 12.5%, moderate 12.5%, severe 25.0%). When dysfunction type was defined as the highest MSISQ domain score, secondary SD was most frequent in both sexes (75.0% men; 76.2% women; p = 0.49). Women showed higher secondary domain scores at the uncorrected level (p = 0.04), but this did not survive FDR correction. In HRQoL and symptom measures, women reported markedly higher fatigue (FSS 46.1 ± 12.4 vs. 25.5 ± 12.7; p_FDR < 0.001) and poorer physical health indices, including pain-related outcomes. Conclusions: SD has represented a substantial burden within this RRMS sample, with secondary domain predominance in both sexes, highlighting the clinical relevance of symptom-related and functional interference. These findings support the value of multidimensional sexual health assessment in clinical research settings and may be relevant for clinical assessment and future research in MS.

Background/Objectives: Sexual dysfunction (SD) and broader sexual health problems are common after neurological disorders, yet interventional evidence is fragmented across conditions and outcomes. This umbrella review mapped and appraised systematic review-level evidence on interventions targeting SD and sexual health in neurological populations and qualified conclusions using certainty of evidence. Methods: PubMed, Web of Science, Cochrane Library, Embase, PsycINFO, EBSCOhost, and Scopus were searched from inception to 27 November 2025. Two reviewers screened records, extracted data, assessed review quality with AMSTAR 2, and rated certainty across intervention–outcome pairings using a GRADE-informed approach that integrated review confidence and primary-study risk-of-bias as reported by the source reviews. Results: Twenty-six systematic reviews were included. Overall confidence was frequently limited (17/26 critically low and 6/26 low), with only a small subset rated moderate or higher. Evidence was most coherent for phosphodiesterase type 5 (PDE5) inhibitors improving erectile function in men with spinal cord injury, whereas most other interventions and outcomes were supported by low or very low certainty. Women were represented in 16/26 reviews, yet validated female sexual function outcomes were synthesized in 6/26 reviews and relationship/couple outcomes in 3/26; furthermore, 10/26 reviews restricted inclusion to men, and no review synthesized pediatric intervention trials. Conclusions: Evidence supports PDE5 inhibitors for improving erectile function in men with spinal cord injury, while evidence for other interventions and sexual health domains remains limited. Methodological limitations highlight the need for more inclusive trials, broader standardized outcomes, and longer follow-up within neurorehabilitation pathways.

Background:Robotic-assisted therapy (RAT) has emerged as an effective approach to upper limb neurorehabilitation. Among available systems, the Armeo®Spring enables task-oriented, customizable training supported by virtual reality (VR), fostering motivation and neuroplasticity. This retrospective observational study aimed to evaluate longitudinal changes in performance across different VR exercises using Armeo®Spring session data from patients with diverse neurological conditions and to identify tasks exhibiting significant improvement within particular diagnoses, thereby supporting personalized robotic rehabilitation. Methods:The dataset included adults (≥18) with common neurological disorders who completed ≥20 Armeo®Spring sessions using frequent integrated VR exercises. Performance across the first 20 sessions was analyzed using linear mixed-effects models with fixed effects for session, disease, age, sex, difficulty, and mechanical support, and random patient intercepts and slopes. False discovery rate (FDR) correction was applied to identify disease- and task-specific improvement trajectories. Results:After sequential filtering, the final cohort included 71 patients (30 with ischemic stroke, 15 with hemorrhagic stroke, 15 with multiple sclerosis, and 11 with Parkinson's disease) who underwent rehabilitation using five different VR exercises: Balloons, Roll the Ball, Fly High-Elbow, The Goalkeeper, and Pirate Adventure. A significant improvement in Roll the Ball scores was detected for MS (slope = +9.41 points/session, FDR = 0.0015), IS (+9.18 points/session, FDR = 0.0001), and HS (+7.28 points/session, FDR = 0.023). In Fly High (Elbow), MS patients demonstrated a significant improvement (+6.84 points/session, FDR <0.001) as for IS patients (+5.00 points/session, FDR <0.001). Task difficulty was consistently correlated with lower scores across all games (FDR <0.05), whereas age and sex were not significant predictors in the adjusted models. Conclusion:Disease-specific recovery profiles suggest that proximal, multi-joint VR exercises, such as Roll the Ball and Fly High (Elbow), may be particularly effective for patients with multiple sclerosis and ischemic stroke, whereas other exercises show smaller or non-significant improvements. These findings support tailoring VR-based rehabilitation to the patient's neurological condition, enabling targeted, condition-specific exercise selection and progression, which may enhance the effectiveness and efficiency of upper-limb recovery.

INTRODUCTION:Neuromuscular disorders (NMDs) comprise a group of conditions affecting the muscles and/or the nerves controlling them, resulting in progressive muscle weakness. Beyond the physical limitations, NMDs can significantly impact quality of life (QoL), including sexuality. Sexuality, as defined by the World Health Organization, encompasses physical, psychological, and social dimensions. However, research exploring the multifaceted impact of NMDs on sexual well-being remains limited, despite the potential influence of physical impairments, psychological distress, and social stigma. OBJECTIVES:This scoping review aims to synthesize the existing literature on sexuality in individuals with NMDs, identifying the interplay of physical, psychological, and social factors affecting sexual QoL, highlighting research gaps, and informing future research and clinical practice. METHODS:A scoping review was conducted using PubMed, Web of Science, Cochrane Library, Embase, and Scopus databases (up to May 15, 2025) to identify studies examining sexuality in individuals with NMDs. Studies addressing physical, psychological, and social factors influencing sexual health in NMD patients were included. Data were extracted using a standardized form and synthesized narratively. The review was registered on Open OSF (DOI https://doi.org/10.17605/OSF.IO/RP9U2). RESULTS:Fourteen studies with various conditions such as Duchenne muscular dystrophy, amyotrophic lateral sclerosis (ALS), myotonic dystrophy type 1, myasthenia gravis, and Charcot-Marie-Tooth disease were included, from interviews to surveys. One key theme that emerged was the extent to which personal narratives reveal the emotional weight of stigma, the struggle with body image, and how intimacy is peripheral in medical institutions. In surveys, many said their sexual activity had declined, particularly among people with progressive diseases like ALS and myotonic dystrophy. Many of these studies also pointed to how sexual health was directly associated with QoL, a good reminder that it's an important aspect of well-being that we need to pay more attention to in care and support. CONCLUSION:This scoping review highlights a significant gap in research regarding sexuality in individuals with NMDs. The limited number of studies identified underscores the need for further research to understand the complex interplay of physical, psychosocial, and social factors affecting sexual well-being in this population.

IntroductionThe aim of the study is to investigate the association between fatigue, cognitive impairment, and overall QoL in individuals with Multiple Sclerosis (MS).MethodsFifty-one patients with MS with a confirmed diagnosis of relapsing–remitting multiple sclerosis (RRMS), according to established diagnostic criteria were enrolled. Data were collected at a single time point to examine associations between fatigue, cognitive functioning, neurological disability, and health-related quality of life (QoL). All participants were submitted to a standardized neurological examination, Fatigue symptoms were assessed using the Fatigue Severity Scale (FSS), Modified Fatigue Impact Scale (MFIS) and Fatigue Scale for Motor and Cognitive Functions (FSMC). Cognitive profiles were evaluated with the Brief Repeatable Battery of Neuropsychological Tests (BRB-N), overall Quality of Life with the Multiple Sclerosis Quality Ff Life (MSQOL-54) and the Expanded Disability Status Scale (EDSS) to evaluate the disability status.ResultsOur findings indicate a significative correlation between general FATIGUE and multiple QoL outcomes. Specifically, fatigue was strongly correlated with Health Perception (ρ = 0.63, p < 0.001), Overall Quality of Life (ρ = 0.65, p < 0.001), Role Physical Limitation (ρ = 0.43, p = 0.002), and Role Emotional Limitation (ρ = 0.37, p = 0.007), and is also related to specific aspects of cognitive functioning as well as Symbol Digit Modalities Test (SDMT) (r = −0.38, p = 0.006) and Selective Reminding Test – Delayed (r = −0.36, p = 0.01).DiscussionThese results contribute to a more comprehensive understanding of disease burden in MS, highlighting fatigue as a key factor that interacts with multiple dimensions of patient functioning.Clinical trial registrationIdentifier (NCT 05783999).

Background/Objectives: Dementia leads to cognitive decline, affecting memory, reasoning, and daily activities, often requiring full-time care. Multisensory stimulation (MSS), combined with cognitive tasks, can slow this decline, improving mood, communication, and overall quality of life. This systematic review aims to explore methods that utilize MSS in the rehabilitation of patients with dementia. Its clinical value is rooted in its ability to offer a deep comprehension of how MSS can be successfully incorporated into rehabilitation treatments. Methods: Studies were identified from an online search of PubMed, EBSCOhost, Cochrane Library, Web of Science, Embase, and Scopus databases with a search time frame from 2014 to 2024. This review has been registered on Open OSF (n) 3KUQX. Results: Pilot studies investigating MSS interventions, encompassing Cognitive Stimulation Therapy (CST), Sonas therapy, and combined physical–cognitive exercise programs, have yielded mixed findings in individuals with dementia. CST has demonstrated significant improvements in general cognitive function, particularly in language skills, offering a promising approach for cognitive enhancement. Sonas therapy, while showing positive trends in some studies, does not consistently achieve statistically significant outcomes across all cognitive domains. Conversely, combined exercise programs have shown efficacy in improving dual-task performance, suggesting benefits for motor–cognitive integration. MSS delivered within specialized environments like Snoezelen rooms consistently produces positive effects on mood, reducing agitation and promoting relaxation. Conclusions: This review emphasizes how MSS can enhance cognitive, emotional, and behavioral results for individuals with dementia. It is essential for future research to standardize protocols, incorporate advanced technologies such as virtual reality, and rectify diversity gaps. Collaboration between different fields will improve the effectiveness and usefulness of MSS in caring for individuals with dementia.

BackgroundDementia is characterized by a deterioration in cognitive functions that impacts everyday tasks and overall life quality, with Alzheimer's disease (AD) being the most prevalent form. As dementia progresses, cognitive rehabilitation, often utilized in conjunction with telemedicine, offers significant support via targeted interventions that enhance autonomy and overall quality of life (QoL).ObjectiveThis systematic review aims to explore the potential and barriers of telemedicine-based cognitive stimulation and training programs for individuals with dementia and mild cognitive impairment (MCI).MethodsStudies were identified from an online search of PubMed, Web of Science, Embase, PsychINFO, and Scopus databases conducted up to 19 February 2025. This systematic review has been registered on PROSPERO under the following number: CRD42024615619.ResultsThe studies establish that digital health interventions and telehealth approaches add to the improvement in cognitive rehabilitation among patients with dementia and MCI, by indicating striking improvements not only in cognitive functioning but also in increased support for caregivers. The higher adherence and satisfaction rates with such interventions can be attributed to telemedicine itself and newer technologies such as virtual reality (VR) and transcranial direct current stimulation, which can provide options for personalized and accessible care in neurodegenerative disease management.ConclusionsTelemedicine-based cognitive rehabilitation in dementia patients, not only achieves improved cognitive functioning but also a better QoL and reduced caregiver burden. Further studies are needed to ensure equal implementation and long-term sustainability of these interventions, possibly with the inclusion of newer technologies such as VR and neuromodulation.

Background/Objective: Parkinson’s disease (PD) is characterized by motor and cognitive impairments that significantly affect quality of life. Robotic-assisted therapies, such as the AMADEO® system, have shown potential in rehabilitating upper limb function but are underexplored in PD. This study aimed to assess the effects of Robotic-Assisted Therapy (RAT) compared to Conventional Physical Therapy (CPT) on cognitive, motor, and functional outcomes in PD patients. Methods: A single-blind, randomized controlled trial was conducted with PD patients allocated to RAT or CPT. Participants were assessed at baseline (T0) and post-intervention (T1) using measures including MoCA, FAB, UPDRS-III, 9-Hole Peg Test, FMA-UE, FIM, and PDQ-39. Statistical analyses included ANCOVA and regression models. Results: RAT led to significant improvements in global cognition (MoCA, p < 0.001) and executive functioning (FAB, p = 0.0002) compared to CPT. Motor function improved, particularly in wrist and hand control (FMA-UE), whereas changes in fine motor dexterity (9-Hole Peg Test) were less consistent and did not reach robust significance. No significant improvements were observed in broader quality of life domains, depressive symptoms, or memory-related cognitive measures. However, quality of life improved significantly in the stigma subdomain of the PDQ-39 (p = 0.0075). Regression analyses showed that baseline motor impairment predicted cognitive outcomes. Conclusions: RAT demonstrated superior cognitive and motor benefits in PD patients compared to CPT. These results support the integration of robotic rehabilitation into PD management. Further studies with larger sample sizes and long-term follow-up are needed to validate these findings and assess their sustainability.

BackgroundSubjective Cognitive Decline (SCD) is increasingly recognized as a preclinical stage of Alzheimer’s disease (AD), representing a critical window for early detection and intervention. Understanding the structural and functional neural changes in SCD can improve diagnosis, monitoring, and management of this early stage of disease.MethodsA systematic review was conducted using PubMed, Web of Science, and Scopus databases to identify studies examining neuroanatomical, neurofunctional, and neuroimaging findings in individuals with SCD. Inclusion criteria emphasized studies exploring SCD’s potential as an early biomarker for AD progression.ResultsA total of 2.283 studies were screened, with 17 meeting the inclusion criteria. Evidence indicates that SCD is associated with cortical thinning and reductions in gray matter volume (GMV), particularly in the hippocampus, entorhinal cortex, and medial temporal lobe. Functional imaging studies reveal disruptions in the default mode network (DMN), executive control networks (ECN), and sensorimotor networks (SMN), indicating both compensatory mechanisms and early dysfunction. Dynamic functional connectivity studies report reduced brain activity efficiency, while graph theory analyses show decreased network integration. Advanced neuroimaging techniques and machine learning (ML) approaches demonstrate significant promise in detecting subtle neural changes in SCD, with applications for early diagnosis and monitoring disease progression.ConclusionSCD represents a heterogeneous condition characterized by mixed compensatory and degenerative neural changes, marking a critical early stage in the AD continuum. Combining structural and functional brain alterations with advanced neuroimaging and ML methodologies provides valuable biomarkers for early detection. Future longitudinal and multimodal studies are essential to standardize methodologies, account for individual variability, and develop personalized interventions aimed at mitigating progression to dementia.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024616052, CRD42024616052.

Background/Objectives: In recent years, the popularity of non-verbal cognitive training for aphasia has increased. Building on evidence that language abilities engage brain areas involved in executive functions (EFs) processing, this review aims to analyze the utility of EFs training alone or combined with traditional rehabilitation approaches to improve language abilities in aphasia. Methods: Systematic searches were performed in four databases evaluating studies focusing on the effects of EFs training in language rehabilitation, yielding 185 studies. After reading the full text of the selected studies and applying predefined inclusion criteria, nine studies were included based on pertinence and relevance to the topic. This systematic review has been registered in the Prospective Register of Systematic Reviews (PROSPERO 2024) with the number CRD42024519087. Results: The results of the analyzed studies indicate that various EFs training methods, such as computer-assisted executive control training, Cognitive Flexibility in Aphasia Therapy (CFAT), and the Dr. Neuronowski® program, as well as the combination of transcranial direct current stimulation (tDCS) with EFs training, can lead to improvements in language abilities in people with aphasia. Additionally, EFs training often results in specific effects on treated functions like working memory (near transfer effects) and untreated ones such as spoken sentence comprehension (far transfer effects). Conclusions: Despite the heterogeneity of the treatments and the small simple size of the studies analyzed, preliminary results are promising. Future research should further explore the effectiveness and specific contribution of EFs training to improving language functions in aphasia.

Background and Objective: Fatigue represents a hallmark symptom in Multiple Sclerosis (MS), but its diagnosis and clinical evaluation is difficult because it is described as a subjective feeling of exhausted physical and mental sensation. Studies have also shown that approaches based on assisted therapies and robotics, as well as the use of vibration, which are used to improve sensory integration, reduce fatigue. The primary outcome in this study is to evaluate the effects of the application of focal vibrations on the reduction in fatigue, muscle strength, and endurance in MS patients with moderate disability. The secondary outcome is to assess the effects on quality of life, cognitive status, and mood. Methods: We enrolled 40 MS patients. The study was designed as a parallel randomized controlled trial: 20 patients were assigned to the experimental group (EG), who received vibration training, and 20 to the control group (CG), who received traditional physical exercise. Results: We found significant differences in the EG in fatigue, motor, and cognitive outcome and improvement of some aspects of quality of life (QoL). There are correlations between perceived multidimensional fatigue and cadence, step length, and health quality of life composite. Conclusions: Our study demonstrated the potential effectiveness of vibration training in balance, walking endurance, and reduction in the risk of falls in patients with Multiple Sclerosis. In addition, we added evidence about fatigue, non-motor outcomes, in particular promoting mental and physical QoL and individual life satisfaction. The name of the registry is clinicaltrial.gov; the number of registration id NCT05783999; and the date of registration is 14 March 2023.

Introduction:Neurodegenerative diseases, such as Alzheimer's Disease (AD), are increasingly prevalent, emphasizing the need for early diagnosis and effective intervention. This study explores the feasibility of using the humanoid robot Pepper to administer cognitive assessments for Mild Cognitive Impairment (MCI). Specifically, it evaluates the usability, accuracy, and patient experience of robot-administered cognitive testing compared to traditional assessments conducted by neuropsychologists. Methods:A total of 100 MCI patients were randomly assigned to two groups: one undergoing the Mini-Mental State Examination (MMSE) with Pepper and the other receiving the same test administered by a neuropsychologist. After that participants were submitted to a Satisfaction Questionnaire (SQ) designed to assess their emotional and experiential response to the testing procedure, whether administered by a human or a robot. Results:The intergroup analysis (EG vs. CG) reveals significant differences in age (p = 0.003) and Total SQ (p = 0.01), and in SQ2 (χ 2 = 9.76; df = 1; p = 0.002), SQ4 (χ 2 = 5.02; df = 1; p = 0.02), SQ5 (χ 2 = 25.35; df = 1; p < 0.001), SQ6 (χ 2 = 7.68; df = 1; p = 0.006) and SQ7 (χ 2 = 7.56; df = 1; p = 0.006). Results indicate no significant differences in MMSE scores between the two groups, suggesting comparable cognitive evaluation accuracy. However, participants assessed by Pepper reported lower frustration levels and higher satisfaction (90% vs. 40%) compared to those tested by a neuropsychologist. Additionally, 92% of patients in the robot-assisted group expressed willingness to retake the test in the same manner, indicating high acceptability and engagement. Discussion:These findings suggest that robot-assisted cognitive assessments may enhance patient comfort and accessibility to neuropsychological testing. The integration of Artificial Intelligence (AI) further supports diagnostic accuracy and predictive potential, offering promising avenues for early intervention in neurodegenerative diseases.

Background/Objectives: Cardiovascular diseases (CVDs) encompass a wide range of heart and vascular conditions and remain the leading cause of death worldwide. Acceptance and Commitment Therapy (ACT) is a psychotherapeutic approach that integrates acceptance, mindfulness, and commitment to value-based actions. This systematic review aims to explore the current evidence on the potential role of ACT interventions in supporting psychological well-being among individuals with CVDs. Methods: A systematic review was conducted in accordance with PRISMA guidelines. A search of the literature was conducted through Scopus, PubMed, Web of Science, Cochrane, and PsycINFO databases. Six studies met the inclusion criteria. Results: The reviewed studies suggest that ACT may promote psychological flexibility, emotion regulation, and self-care behaviors in patients with CVDs. Reported outcomes include improved mindfulness, reduced distress, and enhanced quality of life. However, the evidence base is limited in both size and methodological rigor, with included studies varying in design and population. Conclusions: While preliminary findings indicate that ACT shows promise in addressing psychological aspects of CVDs, the current evidence remains insufficient to draw definitive conclusions. Further high-quality, large-scale studies are needed to evaluate the effectiveness and clinical applicability of ACT in cardiovascular populations.

Introduction:Insomnia is highly prevalent in neurodegenerative disorders, yet pharmacological options carry safety and tolerability concerns. This scoping review mapped contemporary evidence for cognitive behavioral therapy for insomnia (CBT-I) across Alzheimer's disease (AD), mild cognitive impairment (MCI), and Parkinson's disease (PD). Methods:Following a preregistered protocol (OSF DOI: 10.17605/OSF.IO/8VP3F), we searched PubMed, Cochrane Library, Web of Science, and Scopus for studies published 2015-2025. We screened English-language studies in adults and applied dual independent review with consensus resolution. Of 105 records, 70 were screened after de-duplication, and 8 met eligibility criteria. Results:Across randomized trials, pilot and feasibility studies, and single-case experimental designs, CBT-I-delivered in person or via telehealth-consistently reduced insomnia severity and improved sleep quality, with frequent ancillary gains in mood, anxiety, and daytime functioning. Remote and digitally augmented delivery appeared feasible and acceptable for cognitively vulnerable adults and caregivers. Early signals suggested potential cognitive benefits in prodromal populations (AD/MCI), and exploratory observations linked improved sleep with plausible neurobiological mechanisms such as amyloid-beta dynamics. In PD, findings aligned with a mechanistic pathway in which presleep cognitive arousal, safety behaviors, and dysfunctional sleep beliefs are modifiable targets. Non-pharmacological comparators (e.g., mindfulness, therapeutic exercise, neuromodulation) also showed benefits, helping contextualize where CBT-I may offer disorder-relevant leverage on insomnia outcomes. Discussion:The overall strength of evidence is tempered by small samples, heterogeneity in comparators and dosing, short follow-up, and inconsistent reporting of clinically meaningful change. Priorities include multicenter randomized trials with standardized sleep and cognitive endpoints, longer observation, head-to-head comparative effectiveness with economic evaluation, adaptive protocols tailored to PD-specific disruptors, and mechanistic studies integrating digital phenotyping and biomarkers to test durability and downstream clinical impact.