BACKGROUND
Cognitive impairment is highly prevalent after stroke, and effective long-term rehabilitation strategies remain limited. Mindlenses Professional is a medical device that combines prism adaptation, delivered through wearable prismatic glasses, with tablet-based digital cognitive training using serious games.
OBJECTIVE
To evaluate the efficacy of Mindlenses Professional, compared with standard paper-and-pencil cognitive rehabilitation, on multiple cognitive outcomes in participants with stroke over a 6-month follow-up.
METHODS
In this randomized controlled clinical trial, 60 participants with stroke underwent 10 rehabilitation sessions over 2 weeks. Neuropsychological assessments were performed at baseline (T0), immediately after treatment (T1), and at 3- and 6-month follow-ups (T2-T3). Composite scores were computed for visual perception, hemineglect, language, memory, and executive functions. Longitudinal changes were analyzed using linear and generalized linear mixed-effects models, with group, lesion side, and time as fixed factors.
RESULTS
Compared with standard rehabilitation (control group), the use of Mindlenses Professional induced greater and sustained improvements in hemineglect and language. The experimental group showed significant advantages for hemineglect at 3 months and for language at all posttreatment time points. In the memory domain, significant gains emerged from 3 months onward and further increased at 6 months. Executive functions improved in both groups, with a differential temporal pattern influenced by lesion side and a marked long-term advantage in participants with right-hemisphere stroke treated with Mindlenses. Visuoperceptual performance remained stable in the experimental group, whereas it declined over time in the control group.
CONCLUSION
These findings support the integration of prism adaptation and digital cognitive training as a safe, feasible, and promising approach for long-term poststroke cognitive rehabilitation.
CLINICAL TRIAL REGISTRATION
NCT07322614; retrospectively registered on January 7, 2026.
A. Stanzione, E. Casula, Giulia Caruso et al.· Annals of Physical and Rehab...· 0 citations
Introduction Cognitive reserve (CR) has been proposed as a key factor explaining inter-individual variability in cognitive performance despite comparable neuropathology. However, its role across the Alzheimer’s disease (AD) continuum remains unclear. This study investigates stage-dependent effects of CR on the relationship between memory performance and brain structural network integrity across healthy subjects (HS), individuals with subjective cognitive decline (SCD), and patients with amnestic mild cognitive impairment (a-MCI), and AD dementia. Materials and methods A total of 209 participants underwent a comprehensive neuropsychological assessment and 3T MRI. Source-based morphometry identified three grey matter structural covariance networks, involving orbitofrontal-temporal-insular regions (OTIN), precuneus-posterior cingulate cortex (PreCiN), and cingulate-hippocampal regions (CHiN). A composite memory score was derived using factor analysis. Regression and moderation models examined the predictive and moderating effects of CR (operationalized as years of education) and network integrity on cognitive performance within each group. Results OTIN and PreCiN showed progressive structural vulnerability along the AD continuum, whereas CHiN showed no significant between-group differences. Across the sample, OTIN and PreCiN integrity significantly predicted cognitive performance. In HS, CR was positively associated with memory performance independently of structural network integrity, suggesting an additive protective role of cognitive reserve in healthy aging. In the SCD group, CR was not directly associated with memory, and only limited effects emerged, indicating early alterations in reserve-related processes. In a-MCI patients, the significant interaction between CR and OTIN integrity suggested patterns consistent with compensatory mechanisms, with higher reserve supporting memory despite structural decline. In AD patients, CR and its interaction with structural networks no longer predicted cognitive outcomes, suggesting a possible exhaustion of reserve capacity. Conclusion These findings support a stage-dependent model of CR, characterized by an additive protective role in healthy aging, patterns consistent with compensatory recruitment in early cognitive decline, and a possible loss of reserve effectiveness beyond a critical neuropathological threshold. Distinct network vulnerabilities and stage-specific CR effects highlight potential windows for reserve-enhancing interventions across the AD continuum.
Laura Serra, Sabrina Bonarota, Giulia Caruso et al.· Frontiers in Human Neuroscie...· 0 citations
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