Stroke is one of the leading causes of long-term disability among adults and contributes to major socio-economic burden globally. Stroke frequently results in multifaceted impairments including motor, cognitive and emotion deficits. In recent years, brain-computer interface (BCI)-based therapy has shown promising results for post-stroke motor rehabilitation. In spite of the success received by BCI-based interventions in the motor domain, non-motor impairments are yet to receive similar attention in research and clinical settings. Some preliminary encouraging results in post-stroke cognitive rehabilitation using BCI seem to suggest that it may also hold potential for treating non-motor deficits such as cognitive and emotion impairments. Moreover, past studies have shown an intricate relationship between motor, cognitive and emotion functions which might influence the overall post-stroke rehabilitation outcome. A number of studies highlight the inability of current treatment protocols to account for the implicit interplay between motor, cognitive and emotion functions. This indicates the necessity to explore an all-inclusive treatment plan targeting the synergistic influence of these standalone interventions. This approach may lead to better overall recovery than treating the individual deficits in isolation. In this paper, we review the recent advances in BCI-based post-stroke motor rehabilitation and highlight the potential for the use of BCI systems beyond the motor domain, in particular, in improving cognition and emotion of stroke patients. Building on the current results and findings of studies in individual domains, we next discuss the possibility of a holistic BCI system for motor, cognitive and affect rehabilitation which may synergistically promote restorative neuroplasticity. Such a system would provide an all-encompassing rehabilitation platform, leading to overarching clinical outcomes and transfer of these outcomes to a better quality of living. This is one of the first works to analyse the possibility of targeting cross-domain influence of post-stroke functional recovery enabled by BCI-based rehabilitation.

https://iopscience.iop.org/article/10.1088/1741-2552/aba162/pdf

BCI for stroke rehabilitation: motor and beyond.

Neurodegenerative diseases (NDs) including Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, and Huntington’s disease are incurable and affect millions of people worldwide. The development of treatments for this unmet clinical need is a major global research challenge. Computer-aided drug design (CADD) methods minimize the huge number of ligands that could be screened in biological assays, reducing the cost, time, and effort required to develop new drugs. In this review, we provide an introduction to CADD and examine the progress in applying CADD and other molecular docking studies to NDs. We provide an updated overview of potential therapeutic targets for various NDs and discuss some of the advantages and disadvantages of these tools.

Advances in Applying Computer-Aided Drug Design for Neurodegenerative Diseases

Prospective memory is a core neurocognitive ability that refers to memory for future intentions, such as remembering to take medications and to switch off appliances. Any breakdown in prospective memory, therefore, has serious implications for the ability to function independently in everyday life. In many neurological disorders, including Parkinson disease and dementia, prospective memory deficits are common even in the earliest stages and typically become more severe with disease progression. Consequently, clinical assessment of prospective memory is of critical importance. This article provides an overview of the various manifestations and neural bases of prospective memory deficits. To facilitate clinical decision-making, validated measures of this construct are identified and their suitability for clinical practice is discussed, focusing in particular on clinical sensitivity and psychometric properties. The article concludes by reviewing the approaches that can be used to rehabilitate different types of prospective memory impairment, and algorithms to guide the evaluation and treatment of these impairments are provided.

Prospective memory impairment in neurological disorders: implications and management

The Reading the Mind in the Eyes Test, Iowa Gambling Task and Interpersonal Reactivity Index: Normative Data in an Italian Population Sample.

Background: Difficulties in social cognition and interaction can characterise adults with unilateral right hemisphere brain damage (RHD). Some pertinent evidence involves their apparently poor reasoning from a “Theory of Mind” perspective, which requires a capacity to attribute thoughts, beliefs, and intentions in order to understand other people's behaviour. Theory of Mind is typically assessed with tasks that induce conflicting mental representations. Prior research with a commonly used text task reported that adults with RHD were less accurate in drawing causal inferences about mental states than at making non‐mental‐state causal inferences from control texts. However, the Theory of Mind and control texts differed in the number and nature of competing discourse entity representations. This stimulus discrepancy, together with the explicit measure of causal inferencing, likely put the adults with RHD at a disadvantage on the Theory of Mind texts. This project was supported in part by grant # DC01820 from the National Institute on Deafness and Other Communicative Disorders. The authors are indebted to Denise Balason, Meghan Capellini, Bethany Peters, Anita Lewis, Sara Byers, and Annie Palaika for their assistance. Aims: This study revisited the question of Theory of Mind deficit in adults with RHD. The aforementioned Theory of Mind texts were used but new control texts were written to address stimulus discrepancies, and causal inferencing was assessed relatively implicitly. Adults with RHD were hypothesised not to display a Theory of Mind deficit under these conditions. Methods & Procedures: The participants were 22 adults with unilateral RHD from cerebrovascular accident, and 38 adults without brain damage. Participants listened to spoken texts that targeted either mental‐state or non‐mental‐state causal inferences. Each text was followed by spoken True/False probe sentences, to gauge target inference comprehension. Both accuracy and RT data were recorded. Data were analysed with mixed, two‐way Analyses of Variance (Group by Text Type). Outcomes & Results: There was a main effect of Text Type in both accuracy and RT analyses, with a performance advantage for the Theory of Mind/mental‐state inference stimuli. The control group was faster at responding, and primed more for the target inferences, than the RHD group. The overall advantage for Theory of Mind texts was traceable to one highly conventional inference: someone tells a white lie to be polite. Particularly poor performance in mental‐state causal inferencing was not related to neglect or lesion site for the group with RHD. Conclusions: With appropriate stimulus controls and a relatively implicit measure of causal inferencing, this study found no “Theory of Mind” deficit for adults with RHD. The utility of the “Theory of Mind” construct is questioned. A better understanding of the social communication difficulties of adults with RHD will enhance clinical management in the future.

A Different Story on Theory of Mind Deficit in Adults with Right Hemisphere Brain Damage

A meta-analytic review of prospection deficits in Parkinson's disease.

Abstract Antenatal depression (AND) affects 1 in 10 fathers, potentially negatively impacting maternal mental health and well-being during and after the transition to parenthood. However, few studies have assessed the social predictors of paternal AND or their possible associations with maternal mental health. We analysed data from 180 couples participating in the Queensland Family Cohort longitudinal study. Both parents completed surveys measuring mental health, relationship quality, social support, and sleep quality at 24 weeks of pregnancy. Mothers also completed the same surveys 6 weeks’ postpartum. Antenatal depression, stress, and anxiety were highest among fathers reporting lower social support and higher sleep impairment. Maternal AND, stress, and anxiety were higher among mothers reporting higher physical pain and poor sleep quality. Postnatally, mothers reporting lower social support also reported higher depression, anxiety, stress, and psycho-social well-being. While there were no significant associations between AND among fathers and maternal antenatal or postnatal depression, an exploratory analysis revealed that mothers whose partners reported lower antenatal social support also reported lower postnatal social support and higher postnatal depression. Our findings highlight the importance of including data among fathers to achieve a whole family approach to well-being during the transition to parenthood. 

/pdf/the-social-predictors-of-paternal-antenatal-mental-health-3h8eqb09.pdf

The social predictors of paternal antenatal mental health and their associations with maternal mental health in the Queensland Family Cohort prospective study

The healthcare industry is a demanding and challenging environment for junior doctors because they must navigate complex medical cases, work long hours and manage high levels of stress. Understanding the individual and contextual factors that impact junior doctors’ wellbeing, leadership and job performance is important for improving patient care and outcomes. Furthermore, given the close connection between psychological wellbeing and work performance, and the necessity of leadership skills within an organisational context, the training that junior doctors receive needs to support these factors. It could even be argued that there is an ethical obligation to incorporate these factors in junior doctor training given the time, energy and financial investment made by junior doctors and the healthcare sector more broadly, not to mention the risk to patient care. Despite extensive research on job attitudes and personality, we still do not know how personality traits and states affect junior doctors’ well-being, leadership and performance; how contextual factors (e.g. senior doctors’ personalities) influence junior doctors and how these relationships evolve over time. In this editorial, we explore the benefits of applying personality science to understand better junior doctors’ well-being, leadership and job performance, and outline the early stages of an associated interdisciplinary research agenda. As we will briefly outline, the findings from such research could have practical implications for healthcare organisations aiming to improve their workforce’s well-being, leadership and performance, and, ultimately, patient care outcomes (e.g. by reducing medical errors). By investigating the links between these factors, researchers can help organisations develop targeted training programmes that address the specific needs and personalities of their employees. For instance, organisations could create training programmes for both junior and senior doctors that focus on improving awareness of their own and their colleagues’ personalities, strengths and preferences, with the goal of instituting long-lasting improvements in healthcare settings that foster healthy working relationships among teams, which ultimately enhance the quality of care provided to patients. We begin by introducing the central concept of personality science: personality traits.

Leveraging personality science to enhance junior doctor well‐being, leadership and performance: It's not just about who we are, but also how we act

We still need to think critically about positive thinking in health care

We argue that willpower as well as its depletion may, in some circumstances, adversely impact on clinical decision‐making and patient care. This psychological phenomenon has been dubbed ego depletion in social psychology. Willpower and its depletion which is known as ‘ego depletion’ are well‐established and validated theoretical constructs in social psychology and have been studied across a range of experimental contexts. Willpower is closely related to the concept of self‐control, which refers to the ability to regulate one's own behaviour and actions in order to pursue and achieve either a short‐ or long‐term goal. We outline the clinical relevance of willpower and its depletion in relation to clinical case examples drawn from three of the authors' clinical experience with the view of developing a clinical‐research agenda for future research studies. We examine willpower and its depletion in the context of three clinical case examples, which include (i) doctor–patient interactions, (ii) willpower and its depletion in relation to challenging interpersonal interactions with clinical and non‐clinical work colleagues and (iii) willpower and its depletion in response to working within a challenging and unpredictable clinical environment. In contrast to the more widely recognised external resources (including space, staff allocations and night shifts), a greater understanding of how this important but under‐recognised internal resource can be depleted in response to a range of different factors within clinical settings has the potential to inform and improve patient care through a renewed focus on the developing interdisciplinary clinical studies which draw upon contemporary findings from social psychology. Future work aimed at developing evidence‐based interventions to help mitigate the negative impact of impaired self‐control and decision fatigue within healthcare systems may in turn lead to improved patient care as well as more effective healthcare service and delivery.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/imj.16121

Self‐control, limited willpower and decision fatigue in healthcare settings

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