Background: There is increasing interest in identifying sensitive cognitive markers for the early detection of Alzheimer’s disease (AD). Spatial navigation has emerged as a promising marker, as impairments in both egocentric and allocentric navigation have been reported in preclinical AD and mild cognitive impairment (MCI). However, findings regarding the relative involvement of these navigational representations remain inconsistent. Moreover, little is known about how MCI affects other forms of spatial representation beyond navigation. Objective: The present study aims to investigate navigational, inner, and outer bodily representations in individuals with MCI, in order to provide a broader characterization of cognitive changes associated with this condition in different space representations. Methods: We conducted a cross-sectional comparative study involving 28 healthy controls (HC) and 25 participants diagnosed with MCI (PtwMCI). All participants completed tasks and questionnaires probing: a) different interoceptive dimensions (interoceptive accuracy [IAcc], awareness [IAw], and sensibility [ISe]); b) action-oriented (aBR) and non–action-oriented (NaBR) body representations; c) landmark, route, and survey knowledge of a virtual environment. Results: PtwMCI showed reduced IAcc and ISe, and performed less accurately in both landmark and route tasks compared to HC. Conclusions: Our findings indicate early impairments in the inner body (interoceptive) and navigational processing, even at the initial stages of cognitive decline. These difficulties may thus represent an early marker of neurodegeneration. This opens new directions for research on how body-related cognitive processes influence broader cognitive functions in the Alzheimer’s disease continuum.

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system and a leading cause of disability in young adults. Traditional measures of MS-related disability primarily rely on objective clinical evaluations, often neglecting patients’ subjective experiences, which are affected by physical, cognitive, and emotional factors. This study aimed to validate the Italian Perceived Disability Scale (IPDS), a 20-item self-report tool designed to assess perceived disability across physical, psychological, and social domains. A cohort of 100 individuals with MS underwent the IPDS and a comprehensive clinical and neuropsychological assessment, including the Expanded Disability Status Scale (EDSS), Fatigue Severity Scale (FSS), Hamilton Depression and Anxiety Rating Scales (HAM-D and HAM-A), and the Brief Repeatable Battery of Neuropsychological Tests (BRB-N). Factor analysis confirmed the five-factor structure of the IPDS, accounting for 75

Cognitive impairment (CI) is a frequent and disabling manifestation of multiple sclerosis (MS), yet its molecular underpinnings remain poorly understood. This study aimed to identify microRNA (miRNA) signatures and related gene expression changes associated with CI in MS. Forty-six people with MS underwent clinical, radiological, and cognitive assessment. Peripheral blood mononuclear cells were collected for miRNA profiling using the miRCURY LNA miRNA Focus PCR Panel and validated through RT-qPCR. Experimentally validated miRNA target genes were retrieved using miRWalk with miRTarBase filtering. Target networks were constructed in Cytoscape, followed by protein–protein interaction analysis using STRING and functional enrichment analysis with database for annotation, visualization, and integrated discovery (DAVID) ( https://davidbioinformatics.nih.gov/ ). Selected target genes were further evaluated by gene expression analysis. The results showed that three miRNAs (i.e., miR-146a-5p, miR-let-7a-5p, and miR-21-5p) were significantly dysregulated in patients with MS with CI compared to those with preserved cognition. Gene expression analysis identified differential regulations of IL-1B, IL-6, SLC16A10, and NEFL, supporting the involvement of inflammatory and neurodegenerative pathways. Correlation analyses indicated specific miRNA–mRNA relationships underlying these alterations. These findings suggest that the combined dysregulation of miR-146a-5p and miR-21-5p, together with their target genes, constitutes a molecular signature associated with CI in MS. This profile could contribute to the development of miRNA-based biomarkers for early detection and monitoring of cognitive dysfunction in MS.

Although there is a growing interest in how different types of space are represented, no study has yet systematically examined the development and organization of inner body, outer body (configurational and action-oriented), and navigational spatial representations within the same sample. The present study investigated age-related differences in these three domains and their organization by comparing school-aged children and young adults. In a cross-sectional study, 138 school-aged children (7–8 and 9–10 years) and 96 young adults (18–35 years) completed six tasks assessing interoceptive accuracy, configurational and action-oriented body representations, and landmark, route, and survey knowledge of a virtual environment. Mixed-design analyses revealed no age-related differences in interoceptive accuracy. In contrast, outer body representations showed distinct developmental trajectories: configurational representation reached adult-like levels by the age of 9–10 years, whereas action-oriented representation continued to mature beyond this age. Concerning navigational space development, landmark and route knowledge were comparable across age groups, while young adults outperformed both groups of children in survey knowledge. Exploratory factor analyses revealed age-related differences in the structural organization and coupling of inner body, outer body, and navigational representations. Overall, the findings highlight distinct developmental trajectories and age-related organization across body-related and navigational spatial representations.

Pure apathy is relatively common in people with Multiple Sclerosis (PwMS), but its neural mechanisms remain unexplored. Therefore, we investigated the neural correlates of pure apathy in PwMS, differentiating it from depression. Sixty-two PwMS underwent neuropsychological assessments and Magnetic Resonance Imaging scans. Pure apathy is primarily associated with lesions in the cortical-limbic-subcortical system implicated in goal-directed behaviour and motivation. Apathy and depression arise from distinct yet partially overlapping neural mechanisms, with basal ganglia and limbic structures playing a key role.

Although recent theoretical accounts suggest potential links among interoceptive processing, functional body representations, and navigation, these domains have rarely been examined together across development, and little is known about how their organization may differ between childhood and adulthood. The present study investigated age-related differences in these three domains and their organization by comparing school-aged children and young adults. In a cross-sectional study, 138 school-aged children (7-8 and 9-10 years) and 96 young adults (18-35 years) completed six tasks assessing interoceptive accuracy, configurational and action-oriented body representations, and landmark, route, and survey knowledge of a virtual environment. Regarding cardiac interoceptive accuracy, mixed-design analyses did not provide evidence of age-related differences. In contrast, functional body representations showed possible distinct developmental trajectories: configurational body representation may reach an adult-like level by the age of 9-10 years, whereas action-oriented body representation may continue to develop beyond this stage. Concerning navigational space development, landmark and route knowledge were comparable across age groups, whereas young adults were more accurate than both child groups in survey knowledge. In addition, exploratory factor analyses suggested that the organization and coupling of these domains may vary across age groups. Overall, the findings suggest possible differences in the developmental trajectories of interoceptive, bodily, and navigational representations and provide preliminary evidence for age-related variation in their organization.

Interoception refers to the process through which the nervous system detects, interprets, and integrates internal bodily signals, forming a dynamic representation of the body's internal state at both conscious and unconscious levels. It is commonly conceptualized along three dimensions: interoceptive accuracy, interoceptive awareness and interoceptive sensitivity. Mental body representation (MBR) is a multifaceted cognitive construct encompassing structural, spatial, lexical, and semantic components of the body. A widely accepted taxonomy distinguishes between two types of MBR: action-oriented representations and non-action-oriented representations. To date, only a few studies have examined interoception and MBR in Parkinson's disease (PD), often yielding inconsistent findings, and no study has directly investigated the relationship between these two domains in this clinical population. This study therefore aims to (1) further characterize interoceptive and MBR profiles in PD and (2) explore their potential association. Twenty-seven patients with PD and twenty-four healthy controls completed a neuropsychological battery assessing global cognitive functioning, interoceptive abilities, MBR, and depressive and apathetic symptoms. Mann-Whitney analyses revealed significantly poorer MBR performance in patients compared with healthy controls. Spearman correlations showed significant associations between action-oriented MBR and global cognitive functioning as measured by the Parkinson's Disease Cognitive Rating Scale (PD-CRS). Regression analyses further demonstrated that PD-CRS performance significantly predicted action-oriented MBR abilities. These findings indicate a characteristic difficulty among individuals with PD in mentally representing body features. Moreover, results suggest that both cortical and subcortical cognitive functions contribute to supporting action-oriented MBR.

Interoception, the sense of inner bodily signals, plays a key role in emotional regulation, cognition and mental health. While its relevance in adulthood has been extensively explored, less is known about how interoceptive abilities develop during adolescence, a period characterised by significant physical and psychological changes. This study aimed to investigate different interoceptive dimensions in adolescents and adults to better understand the developmental profile of this sense. Fifty-four adolescents (aged 12-14) and 50 adults (aged 25-34) completed the Heartbeat Counting Task (HCT) to assess their actual ability to detect heartbeats, their confidence in this ability, and the confidence-accuracy correspondence, and a questionnaire on the tendency to focus on different bodily sensations. The study also examined where participants localised bodily sensations during the HCT. No clear group differences emerged in the accuracy during the HCT. Also, both age groups exhibited similar body localisation patterns, primarily focusing on the chest during heartbeat detection. However, adolescents showed significantly lower metacognitive awareness of their ability to perceive cardiac signals, and higher focus on interoceptive sensations, as reflected in their higher confidence ratings in the HCT and elevated scores on a questionnaire assessing the perceived frequency of internal bodily sensations. There were no significant correlations among the interoceptive measures in either group, suggesting that they may capture partially distinct aspects of interoceptive functioning and contributing to the ongoing debate on how interoceptive dimensions should be conceptualized and measured. Overall, these findings suggest that, while basic interoceptive detection may be established by early adolescence, the capacity to accurately reflect on these internal sensations continues to mature into adulthood, at least for what attains the cardiac domain. Also, the mismatch observed between adolescents' heightened bodily focus and their limited metacognitive insight may partly help explain why adolescence is a period of increased vulnerability to mental health difficulties.

Objective Theory of Mind (ToM) deficits are common in people with Multiple Sclerosis (PwMS). This pilot study evaluated the feasibility of an ecologically valid ToM training in PwMS and examined whether experimental transcranial direct current stimulation (tDCS) intervention targeting the prefrontal cortex could enhance its effects on cognitive and affective ToM components across verbal and nonverbal modalities. Methods Two studies were conducted. Study 1 employed a single-case design with three PwMS undergoing a 16-week video-based ToM training. ToM performance was assessed at baseline, post-intervention, and 3-month follow-up. Study 2 included 12 PwMS randomly assigned to receive ToM training with either active tDCS (dlPFC or vmPFC) or sham stimulation. tDCS was delivered twice weekly (2mA, 20 minutes) over 16 weeks. Results In Study 1, participants showed improvements in cognitive ToM (verbal and nonverbal), and selective improvement in verbal affective ToM. In Study 2, both active tDCS groups exhibited improvements in cognitive and affective ToM compared to the sham group. Conclusions ToM training seems to be useful in improving cognitive and verbal affective ToM in PwMS, especially when combined with prefrontal tDCS. However, nonverbal affective ToM appears resistant to intervention, suggesting the need for targeted strategies. These preliminary findings support a personalized, multimodal approach to social cognitive rehabilitation in MS.

OBJECTIVE:Moral cognition has been insufficiently studied in people with multiple sclerosis (pwMS). This study investigated moral decision making and judgment using ecologically valid moral dilemmas in relapsing-remitting multiple sclerosis (MS) and progressive MS phenotypes, exploring associations with clinical and psychological variables. METHOD:Twenty-one individuals with relapsing-remitting MS and 21 with progressive MS completed a battery of moral dilemmas (instrumental, incidental, and ecological) and questionnaires assessing quality of life, mood, alexithymia, and empathy. Data from pwMS were compared to those of 56 age- and education-matched healthy controls. Group differences were analyzed using Mann-Whitney U tests, and effect sizes (r) were reported. RESULTS:Compared to healthy controls, pwMS showed significantly higher moral acceptability in instrumental (U = 633.0, p = .001, r = 0.39), incidental (U = 745.5, p = .035, r = 0.23), and ecological dilemmas (U = 563.0, p < .001, r = 0.44). Moral permissiveness was positively correlated with disability (Expanded Disability Status Scale: ρ = 0.36, p = .019) and negatively with physical quality of life (Multiple Sclerosis Quality of Life-Physical: ρ = -0.33, p = .034) and inhibitory control (Stroop Test: ρ = 0.47, p = .002). Empathy scores were inversely correlated with moral acceptability across all dilemmas (p < .05). CONCLUSIONS:PwMS exhibit increased moral permissiveness, particularly in relation to clinical disability, physical functioning, and executive control. These findings contribute to characterizing the sociocognitive profile of MS and support the inclusion of moral cognition in future research, though implications for patient care remain preliminary. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Apathy is a common neuropsychiatric symptom in people with Multiple Sclerosis (PwMS), and is significantly associated with increased dependency on caregivers, intensifying their emotional and physical burden. The present study aims to evaluate apathy from the perspectives of both PwMS and caregivers, considering the MS clinical phenotype; and to explore the impact of caregiver-reported patient apathy on their distress, particularly in relation to their coping strategies and resilience. Eighty dyads of PwMS and caregivers completed the self-evaluation or caregiver version of the Apathy-Motivation Index, which assesses apathy in terms of behavioral activation, social motivation, and emotional sensitivity. Caregivers also completed the Zarit Burden Interview and the Caregiver Burden Inventory to assess burden, the Coping Orientation to Problems Experienced to evaluate coping strategies, and the Connor-Davidson Resilience Scale to measure resilience. Caregivers consistently reported higher levels of perceived patient apathy than PwMS, particularly in terms of behavioral apathy. Notably, higher levels of emotional apathy in PwMS, as perceived by caregivers, were strongly associated with increased psychological distress and burden. Furthermore, caregivers relying on maladaptive coping strategies experienced significantly greater levels of emotional exhaustion and role strain related to caregiver-reported patient apathy. These findings highlight the need to comprehensively assess all dimensions of apathy and integrate the caregiver’s perspective in its assessment. Tailored interventions should focus on reinforcing adaptive coping mechanisms to mitigate caregiver distress, associated with caregiver-reported patient apathy, ultimately improving the well-being of both PwMS and their caregivers.

Interoception, the sense of inner bodily signals, plays a key role in emotional regulation, cognition and mental health. While its relevance in adulthood has been extensively explored, less is known about how these abilities develop during adolescence, a period characterised by significant physical and psychological changes. This study aimed to investigate three distinct dimensions of interoception — accuracy, sensitivity and awareness — in adolescents and adults to better understand the developmental profile of this sense. Fifty-four adolescents (aged 12–14) and 50 adults (aged 25–34) completed the Heartbeat Monitoring Task to assess their actual ability to detect heartbeats, their confidence in this ability, and the confidence-accuracy correspondence, and a questionnaire on the tendency to focus on bodily sensations. The study also examined where participants localised bodily sensations during the interoceptive task. The results revealed no significant differences in interoceptive accuracy between the two groups. Both age groups exhibited similar body localisation patterns, primarily focusing on the chest during heartbeat detection. However, adolescents showed significantly lower metacognitive awareness of their ability to perceive internal bodily sensations, and higher focus on interoceptive sensations, as reflected in their higher confidence ratings and questionnaire scores. No significant correlations emerged among the three interoceptive dimensions in either group, which supports the view that these dimensions represent independent components of interoception. These findings suggest that, while basic interoceptive detection may be established by early adolescence, the capacity to accurately reflect on these internal sensations continues to mature into adulthood. The mismatch observed between adolescents’ heightened bodily focus and their limited metacognitive insight may partly help explain why adolescence is a period of increased vulnerability to mental health difficulties. ### Competing Interest Statement The authors have declared no competing interest.

Background/Objectives: Body representations (BRs) are essential for guiding movements, maintaining spatial awareness, and achieving effective interactions with the environment. Several studies suggest that BRs are frequently impaired following unilateral brain damage, emphasising the need for tailored rehabilitation interventions; however, there is a lack of studies evaluating the effectiveness of training specifically designed to improve different kinds of functional BRs after stroke. Therefore, the present study aimed to present and implement a specific rehabilitation training program for BR alterations and evaluate its effectiveness in a sample of adults with unilateral brain damage. Methods: Nine adults with unilateral brain damage and seven age- and education-matched healthy controls were recruited. Both groups underwent a neuropsychological assessment to evaluate BR (action- and nonaction-oriented). Additionally, functional autonomy and motor functioning were assessed in the patient group. Following an initial assessment (T0), the patients participated in a BR-specific rehabilitation intervention. At the end of the rehabilitation program (T1), both groups were re-evaluated with the same tasks used at T0. Results: At T0, the patient group performed worse on BR tasks than the controls. At T1, a significant improvement in the nonaction-oriented BR and functional autonomy was observed in the patient group. Conclusions: This preliminary study suggests the effectiveness of a targeted rehabilitation intervention for BR in promoting enhanced body boundary awareness and greater accuracy in the perception of body part positions, possibly leading to increased functional autonomy. These findings highlight the importance of incorporating BR training in rehabilitation programs for adults with acquired brain damage, alongside motor rehabilitation.

Numerous risk factors for dementia have been identified, but the concern of how cognitive functions in the mild Neurocognitive Impairment (mild NCI) stage predict dementia occurrence and incidence is still a matter of debate. The present paper aims to fill this gap by conducting an updated meta-analysis of studies examining the probability over time of developing dementia in relation to measures of global cognitive functioning, long-term verbal memory, complex attention, visuoconstructional ability, and language in the mild NCI stage. We conducted a systematic literature search up to March 2024 in PubMed, PsycINFO (PROQUEST), and Scopus databases. We used random-effects models to pool the ratio measure (odds, hazard, or risk ratios) for the association between cognitive domains and the risk of developing dementia in people with mild NCI. The systematic search in electronic databases identified 44 relevant studies. Results showed that better performance in long-term verbal memory, visuoconstructional, and language abilities in individuals with mild NCI were associated with a lower risk of progression to dementia. These findings might suggest that interventions aimed at preserving or enhancing these cognitive domains could be beneficial in delaying or preventing dementia onset, offering a potential therapeutic target for clinicians working with at-risk populations.

OBJECTIVE:Multiple sclerosis (MS) is a neurological condition that affects physical, cognitive, and emotional functions, significantly impacting quality of life (QoL) even in its early stages. Beyond the typical motor, sensory, visual, and brainstem disorders usually assessed by the Expanded Disability Status Scale, MS also impairs functional body representations and interoception, diminishing overall functioning and QoL. In this study, we aim to explore the relationships between functional body representations, interoceptive processes, and major clinical outcomes, including physical disability (Expanded Disability Status Scale), fatigue severity, and health-related QoL in people with MS. METHOD:Fifty-nine people with MS were assessed with tasks assessing body representations, action-oriented and nonaction-oriented, and interoception. RESULTS:Action-oriented and nonaction-oriented body representation performance was significantly associated with fatigue severity (r = -.337 and r = .301, respectively; ps ≤ .021), suggesting that body representations are particularly vulnerable to perceived fatigue in MS. In addition, fatigue severity and bowel/vesical dysfunction were positively correlated with the tendency to overestimate one's own interoceptive capabilities (r = .335 and r = .311, respectively; ps ≤ .017), highlighting the role of MS-related disability in interoception. CONCLUSIONS:These findings underscore the importance of integrating assessments of body representation and interoception into clinical practice to guide therapeutic interventions aimed at improving people with MS outcomes and QoL. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The possible impact of the interindividual variability in interoception on human navigation remains unexplored. However, recent theories suggest that interoceptive inputs are essential for cognition, and evolutionary perspectives link navigation to interoceptive processing related to energy regulation.Building on this evidence, we present three studies on healthy volunteers aimed at exploring whether individual differences in conscious interoceptive dimensions (interoceptive sensibility, accuracy, and awareness) predict individual differences in spatial knowledge of both virtual (Studies 1 and 2) and real-world (Study 3) environments.Study 1 was a web-based study in which 142 participants completed an interoceptive sensibility (ISe) questionnaire and three tasks probing route, landmark, and survey knowledge of an environment acquired from a video presentation. No significant relationship was found between ISe and environmental knowledge, as assessed using virtual navigation tasks.Study 2 extends Study 1 by exploring other relevant interoceptive dimensions, specifically interoceptive accuracy (IAcc) and awareness (IAw), in a laboratory-based setting. In this study, 110 participants completed an ISe questionnaire and the Heartbeat Counting Task to measure IAcc and IAw, as well as desktop-based tasks probing landmark, route, and survey knowledge of a virtual environment. Results from this study provided some indication that higher IAcc could be linked to slower performance in the landmark task.Study 3 moves from a virtual to a real-world environment. A total of 45 participants completed the IAcc, IAw, and ISe measures, as well as tasks that probed landmark, route, and survey knowledge of a real environment and involved first-person, actual navigation. The results suggest a possible link between higher IAcc and better performance in the route and survey tasks.These findings offer new empirical evidence on the relationship between interoception and environmental navigation. Tentatively, while heightened IAcc might impair attention to external cues (landmarks), at least in virtual environments (Study 2), it could enhance real-world navigational tasks of enviroments that have been directly explored from an egocentric perspective (Study 3). However, these findings should be interpreted with caution, as the overall association across studies was weak, and warrant replication in future studies using additional measures of both interoception and navigation.

Restless legs syndrome is a sensorimotor disorder of sleep/wake regulation that frequently coexists with migraine, affecting patients' quality of life. This study aimed to estimate the prevalence of restless legs syndrome in individuals with migraine and to explore the associated clinical, demographic and behavioural aspects. A systematic review and meta-analysis of the existing literature was conducted. Articles were included if they provided data on individuals with migraine, with or without restless legs syndrome and these proportions were used to estimate the prevalence of restless legs syndrome in migraine. A total of 30 studies were included in the meta-analysis. The overall pooled prevalence of restless legs syndrome among individuals with migraine was 20% (95% confidence interval [CI] = 17%-23%). The pooled prevalence of restless legs syndrome was affected by migraine duration (higher prevalence with longer duration), disability (higher prevalence with greater migraine-related disability) and age (higher prevalence in older individuals). A significant association was found between restless legs syndrome, migraine with aura and chronic migraine. No significant sex-related differences were observed. Among behavioural factors, depression, pain and poor sleep quality were significantly associated with restless legs syndrome. These findings suggest that restless legs syndrome is a common comorbidity in migraine with aura and chronic migraine, with a higher prevalence than that reported in the general population. Moreover, specific demographic, clinical and behavioural characteristics may help identify individuals at higher risk. Further studies are needed to clarify the underlying pathophysiological mechanisms and to identify potential therapeutic targets.

IntroductionThis study aims to evaluate the use of computer-based body representation tasks in an adult sample, considering the role of demographic variables and providing correction indices for clinical practice.MethodThree hundred sixty-six healthy participants were assessed in person with a computer-based battery that included the Hand Laterality Task (HLT) to assess action-oriented body representation (aBR), the Frontal Body Evocation Task (FBET) to assess nonaction-oriented body representation (NaBR), and two corresponding control tasks (i.e., the Object Laterality Task and the Christmas Tree Task), to disentangle the effect of cognitive functions required to perform the tasks but independent of body representation processing. In addition to the primary cohort, 305 healthy participants performed similar body representation and control tasks in an unsupervised web-based version, and a subgroup of these (N = 30) underwent the assessment in both the laboratory-based and web-based versions.ResultsConcerning the body representation tasks, multiple linear regression analysis revealed that age and sex significantly influenced aBR accuracy and response time (i.e., the HLT), while the NaBR accuracy and response time (i.e., the FBET) were significantly influenced only by age. A correction grid was constructed from the derived linear equation to adjust raw scores according to demographic variables, and a percentile distribution of adjusted scores was provided for each task. Correlation analyses showed significant and strong correlations between the laboratory-based and web-based versions of the tasks (r ≤ 0.888; ps < 0.001), supporting the use of these tasks for the remote assessment.DiscussionThe provided normative data can be helpful for clinical and research purposes, and we discuss the potential benefits of their use.