PSD's Publications

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    Incorporation of a working memory strategy in GMT tofacilitate serial-order behaviour in brain-injured patients
    (Informa UK Limited, trading as Taylor & Francis Group, 2018-10-01) Anna Emmanouel ; Ellisavet Kontrafouri ; Psarras Nikolaos ; Roy P.C. Kessels ; Luciano Fasotti
    Goal Management Training (GMT) is an effective method for improving disorganisedbehaviour in multistep real-life tasks after brain damage. In the present study weincorporated Working Memory Training (WMT) in GMT to explore their combinedefficacy in facilitating the serial-order maintenance of the steps that had to belearned. GMT+WMT was compared to a control WMT designed for other purposes.For this purpose 18 brain-injured patients (aged 20–54), who were at least 4 monthspost-onset, were randomly assigned to either the GMT+WMT or the WMTtreatment. Inclusion was based on a baseline score of less than six correct steps oneach of two multistep everyday tasks. Alternative versions of these tasks were usedas primary outcome tasks. Pre-treatment and post-treatment comparisons of scoreson these primary tasks and on several secondary neuropsychological measures werecollected. The results show that post-treatment the GMT+WMT group performedsignificantly better than the WMT group on the primary outcome measures and onseveral ecologically valid executive tests that demanded a step-by-stepmaintenance of multiple actions. Time effects were found for both groups on thesecondary measures. Other measures showed no significant differences. Weconclude that our results support the efficacy of the combined GMT+WMT infacilitating performance in everyday multistep tasks.
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    Self-reported and experimentally induced self-disgust is heightened in Parkinson’s disease: Contribution of behavioural symptoms
    (PLOS ONE, 2019-10-16) Marianna Tsatali ; Paul G. Overton ; Vivas A.B.
    Parkinson’s disease (PD) is associated with deficits in the recognition and expression of basic emotions, although self-reported levels of the self-conscious emotions shame and embarrassment are higher. However, one self-conscious emotion—self-disgust–which has been shown to have a negative impact on psychological wellbeing, has not been investigated in PD before. Here we employed self-report measures of self-conscious emotions, and an emotion induction paradigm involving images of the self, and narrated personal vignettes of instances when patients with PD (and controls) found themselves disgusting. We found that self-reported and induced levels of self-disgust were higher in PD patients than in matched controls, and that trait self-disgust was specifically related to disorders of impulse control in PD patients. Given the link between self-disgust and impaired psychological wellbeing, and the prevalence of anxiety and depression in PD, self-disgust might make a useful therapeutic target for psychological interventions in the condition.
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    Comparison of Laryngoscopic Views between C-MAC™ and Conventional Laryngoscopy in Patients with Multiple Preoperative Prognostic Criteria of Difficult Intubation. An Observational Cross-Sectional Study
    (MDPI, 2019-11-27) Marianna Tsatali ; Aikaterini Soumpourou ; Panagiota Papakonstantinou ; Dimitrios Gkinas ; Ioannis Dalakakis ; Evangelia Papapostolou ; Anastasia Nikopoulou ; Konstantinos Sapalidis ; Christoforos Kosmidis ; Charilaos Koulouris ; Dimitrios Giannakidis ; Konstantinos Romanidis ; Panagoula Oikonomou ; Aris Ioannidis ; Kosmas Tsakiridis ; Anastasios Vagionas ; Isaak Kesisoglou ; Vasilios Grosomanidi
    Background and Objectives: Video laryngoscopy has been proven useful under difficult airway scenarios, but it is unclear whether anticipated improvement of visualization is related to specific difficult intubation prognostic factors. The present study evaluated the change in laryngoscopic view between conventional and C-MAC® laryngoscopy and the presence of multiple difficult intubation risk factors. Materials and Methods: Patients scheduled for elective surgery with >2 difficult intubation factors, (Mallampati, thyromental distance (TMD), interinscisor gap, buck teeth, upper lip bite test, cervical motility, body mass index (BMI)) were eligible. Patients underwent direct laryngoscopy (DL) followed by C-MAC™ laryngoscopy (VL) and intubation. Change of view between DL and VL, time for best view, intubation difficulty scale (IDS) and correlation between prognostic factors, laryngoscopic view improvement, and IDS were measured. Results: One-hundred and seventy-six patients completed the study. VL lead to fewer Cormarck–Lehane (C/L) III-IV, compared to DL (13.6% versus 54.6%, p < 0.001). The time to best view was also shorter (VL: 10.82 s, DL: 12.08 s, p = 0.19). Mallampati III-IV and TMD ≤ 6 cm were related to improvement of C/L between DL and VL. Logistic regression showed these two factors to be a significant risk factor of the glottis view change (p = 0.006, AUC-ROC = 0.57, 95% CI: 0.47–0.66). 175/176 patients were intubated with VL. 108/176 were graded as 0 < IDS ≤ 5 and 12/176 as IDS > 5. IDS was only correlated to the VL view (p < 0.0001). Conclusion: VL improved laryngoscopic view in patients with multiple factors of difficult intubation. Mallampati and TMD were related to the improved view. However, intubation difficulty was only related to the VL view and not to prognostic factors.
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    Time course of the inhibitory tagging effect in ongoing emotional processing. A HD-tDCS study
    (Elsevier, 2019-12) Victor Martinez-Perez ; Alejandro Castillo ; Noelia Sanchez-Perez ; Vivas A.B. ; Guillermo Campoy ; Luis J. Fuentes
    When a cueing procedure that usually triggers inhibition of return (IOR) effects is combined with tasks that tap semantic processing, or involve response-based conflict, an inhibitory tagging (IT) emerges that disrupts responses to stimuli at inhibited locations. IT seems to involve the executive prefrontal cortex, mainly the left dorsolateral prefrontal cortex (DLPFC), in cognitive conflict tasks. Contrary to other inhibitory effects, IT has been observed with rather short intervals, concretely when the stimulus onset asynchrony (SOA) between the prime presented at the cued location, and the subsequent target is 250 ms. Here we asked whether IT is also applied to ongoing emotional processing, and whether the left DLPFC plays a causal role in IT using HD-tDCS. In two experiments with an emotional conflict task, we observed reduced conflict effects, the signature of IT, when the prime word was presented at the cued location, and once again when the prime-target SOA was just 250 ms. Also, the IT effect was eliminated when cathodal stimulation was applied to the left DLPFC. These findings suggest that the IT effect involves areas of the executive attention network and cooperates with IOR to favor attentional allocation to novel unexplored objects/locations, irrespective of their emotional content.
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    Executive functions in French-Greek early bilinguals: In search of the suggested bilingual advantage
    (EKT, NATIONAL DOCUMENTATION CENTRE, 2020) Chrysochoou E. ; Styliani Kanaki ; Vivas A.B.
    Bilinguals must manage two languages on a daily basis, which requires, among other things, dealing with cross-linguistic interference. Such cognitive training is assumed to underlie better performance of bilinguals, relative to monolinguals, in non-verbal cognitive tasks. Ηowever, the suggested advantage has recently been questioned. The present study aimed at shedding light into this debate, focusing on French-Greek early bilingual adults. Exposure to two languages from the first few years of life has been suggested to favour the demonstration of an advantage. Bilinguals were compared to Greek-speaking monolingual adults (matched for age, gender, non-verbal intelligence, and SES) on executive function tasks, tapping switching, inhibition, and updating processes. Task demands were also manipulated. In line with the suggested advantage and as expected, in the switching paradigm, bilinguals performed faster overall and demonstrated a smaller mixing cost; this can be assumed to reflect better general monitoring and top-down processing for bilingual participants. In contrast, the groups did not differ on switching cost, neither on the inhibition and updating measures. Moreover, contrary to what was expected, the cognitive measures did not correlate with an index of how balanced bilingualism was. Findings do not support a general and robust cognitive advantage in a sample of early bilinguals. Factors that might influence its observation are discussed, along with lines of future research.
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    The moderating effect of bilingualism on lifespan cognitive development
    (Elsevier, 2020) Vivas A.B. ; Elisavet Chrysochoou ; Aristea I Ladas ; Vasiliki Salvari
    A growing amount of studies have explored the possible effects of bilingual experience on cognitive processes such executive functions; the early positive findings were followed by recent studies that have failed to replicate the so-called bilingual advantage. So far, evidence remains scarce with regard to developmental cognitive trajectories through the lifespan, as a function of bilingual experience. In the present work, we analyse a relatively large (N = 326) and comprehensive set of data from Albanian-Greek bilingual and Greek monolingual children (N = 119) and adults (N = 207), who were matched on SES level, intelligence and gender. Participants were assessed with the ANT and the Simon task. Results suggest that bilingual experience moderates age-related changes in monitoring in childhood, with overall RTs negatively related to age in both language groups, yet this relationship is weaker among bilingual children. Similar findings were also observed among adults, with age and monitoring correlated among monolinguals, but not in the bilinguals. Finally, only the monolingual participants showed a significant correlation between age and resistance to interference capacity (Simon effect). In conclusion, bilingualism seems to exert a differential influence on the relationship between age, attentional monitoring and resistance to interference capacity depending on the developmental phase studied and the measures obtained.
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    A survey on the training needs of caregivers in five European countries
    (John Wiley & Sons Ltd., 2020-03) George Pavlidis ; Carolyn Downs ; T Bartosz Kalinowski ; Ilona Swiatek-Barylska ; Lambros Lazuras ; Antonia Ypsilanti ; Marianna Tsatali
    Aim: This survey explored caregivers' perceived training needs in 5 European countries (United Kingdom, Greece, Bulgaria, Poland and Italy). Background: Training can enhance the professional capacity of caregivers; however, caregivers' training needs within Europe have not been examined recently. Methods: A survey conducted in 2015 captured data from 550 caregivers using a convenience sampling strategy, through a structured questionnaire and additional open-ended items and by conducting statistical and content analysis. Results: The results indicated basic nursing skills and specialization, as well as training in psychology-related skills like time management, emotion regulation, communication and advanced health care systems as the emerging training needs. There were some country differences in specific training need areas. Conclusions: It was concluded that training in basic nursing skills and specialization in nursing specific conditions, in advanced health care systems and in psychology-related skills could add to the professional capacity of European caregivers employed in health and social care. Implications for nursing management: The findings inform about employed caregivers' training needs in Europe, which may contribute in the provision of quality care and organisational efficiency in health and social care.
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    Consensus on the reporting and experimental design of clinical and cognitive-behavioural neurofeedback studies (CRED-nf checklist)
    (BRAIN OXFORD ACADEMIC, 2020-03-16) Ros, T. ; Klados, M.A ; et.al
    Neurofeedback has begun to attract the attention and scrutiny of the scientific and medical mainstream. Here, neurofeedback researchers present a consensus-derived checklist that aims to improve the reporting and experimental design standards in the field.
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    Double-Step Machine Learning Based Procedure for HFOs Detection and Classification
    (MDPI, 2020-04-08) Nicolina Sciaraffa ; Manousos A. Klados ; Gianluca Borghini ; Gianluca Di Flumeri ; Fabio Babiloni ; Pietro Aricò
    The need for automatic detection and classification of high-frequency oscillations (HFOs) as biomarkers of the epileptogenic tissue is strongly felt in the clinical field. In this context, the employment of artificial intelligence methods could be the missing piece to achieve this goal. This work proposed a double-step procedure based on machine learning algorithms and tested it on an intracranial electroencephalogram (iEEG) dataset available online. The first step aimed to define the optimal length for signal segmentation, allowing for an optimal discrimination of segments with HFO relative to those without. In this case, binary classifiers have been tested on a set of energy features. The second step aimed to classify these segments into ripples, fast ripples and fast ripples occurring during ripples. Results suggest that LDA applied to 10 ms segmentation could provide the highest sensitivity (0.874) and 0.776 specificity for the discrimination of HFOs from no-HFO segments. Regarding the three-class classification, non-linear methods provided the highest values (around 90%) in terms of specificity and sensitivity, significantly different to the other three employed algorithms. Therefore, this machine-learning-based procedure could help clinicians to automatically reduce the quantity of irrelevant data.
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    Automatic Recognition of Personality Profiles Using EEG Functional Connectivity during Emotional Processing
    (MDPI, 2020-05-03) Manousos A. Klados ; Panagiota Konstantinidi ; Rosalia Dacosta-Aguayo ; Vasiliki-Despoina Kostaridou ; Alessandro Vinciarelli ; Michalis Zervakis
    Personality is the characteristic set of an individual’s behavioral and emotional patterns that evolve from biological and environmental factors. The recognition of personality profiles is crucial in making human–computer interaction (HCI) applications realistic, more focused, and user friendly. The ability to recognize personality using neuroscientific data underpins the neurobiological basis of personality. This paper aims to automatically recognize personality, combining scalp electroencephalogram (EEG) and machine learning techniques. As the resting state EEG has not so far been proven e cient for predicting personality, we used EEG recordings elicited during emotion processing. This study was based on data from the AMIGOS dataset reflecting the response of 37 healthy participants. Brain networks and graph theoretical parameters were extracted from cleaned EEG signals, while each trait score was dichotomized into low- and high-level using the k-means algorithm. A feature selection algorithm was used afterwards to reduce the feature-set size to the best 10 features to describe each trait separately. Support vector machines (SVM) were finally employed to classify each instance. Our method achieved a classification accuracy of 83.8% for extraversion, 86.5% for agreeableness, 83.8% for conscientiousness, 83.8% for neuroticism, and 73% for openness.
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    Rey Complex Figure Test (RCFT): Norms for the Greek older adult population
    ( 2020-10) Marianna Tsatali ; Anna Emmanouel ; Moses Gialaouzidisa ; Konstantina Avdikou ; Charalampos Stefanatos ; Alexandra Diamantidou ; Eleni Kouroundi ; Chaido Messini ; Magda Tsolaki
    Background The Rey Complex Figure Test (RCFT) is an integral part of every neuropsychological assessment, measuring visuoconstructional abilities in research and clinical practice. Aims Our goal was to create norms for the Greek older adults over 50 years old since there is no previous relevant study in Greece. Methods The RCFT was administered to 228 cognitively intact individuals aged 50 to 87 years (M = 64.12, SD = 8.69) with education from 3 to 23 years (M = 11.5, SD = 4.45). First, regression analyses explored the impact of demographics on RCFT performance. Afterwards, we calculated normative data using raw scores and transformed to percentile scores for RCFT Copy, Immediate recall, Delayed Recall, and Recognition tasks. Results Age and education were predictors of the Copy and Recall trials, whereas gender was not, having as the only exception the Recognition condition. Greek normative data adjusted for age and education level for the three RCFT conditions and gender for the Recognition trial are presented, as well as the relationship between the RCFT sub tasks. Discussion This is the first study measuring the RCFT norms in cognitively intact Greek older adults. Conclusions Future studies should measure the psychometric properties of RCFT in this population.
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    Executive functions in French-Greek early bilinguals: In search of the suggested bilingual advantage
    (EKT, NATIONAL DOCUMENTATION CENTRE, 2020-12) Elisavet Chrysochoou ; Styliani Kanaki ; Vivas A.B.
    Bilinguals must manage two languages on a daily basis, which requires, among other things, dealing with cross-linguistic interference. Such cognitive training is assumed to underlie better performance of bilinguals, relative to monolinguals, in non-verbal cognitive tasks. Ηowever, the suggested advantage has recently been questioned. The present study aimed at shedding light into this debate, focusing on French-Greek early bilingual adults. Exposure to two languages from the first few years of life has been suggested to favour the demonstration of an advantage. Bilinguals were compared to Greek-speaking monolingual adults (matched for age, gender, non-verbal intelligence, and SES) on executive function tasks, tapping switching, inhibition, and updating processes. Task demands were also manipulated. In line with the suggested advantage and as expected, in the switching paradigm, bilinguals performed faster overall and demonstrated a smaller mixing cost; this can be assumed to reflect better general monitoring and top-down processing for bilingual participants. In contrast, the groups did not differ on switching cost, neither on the inhibition and updating measures. Moreover, contrary to what was expected, the cognitive measures did not correlate with an index of how balanced bilingualism was. Findings do not support a general and robust cognitive advantage in a sample of early bilinguals. Factors that might influence its observation are discussed, along with lines of future research.
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    Social Representations of Immigrant Patients: Physicians’ Discourse
    ( 2020-12-21) Vasileios Chatzimpyros ; Aphrodite Baka ; Maria Dikaiou
    With the global increase of migration and the effects of the economic crisis, health systems around the world are facing new challenges. In this context, we investigated the social representations of health provision to immigrant patients, held by physicians. We conducted 40 interviews with Greek physicians working in the public health system, the private health system, the health system in jails, and nongovernmental organizations. Using principles from thematic analysis, results show a social representation of immigrant patients as a burden to the health system. This social representation is constructed by themes focusing on immigrant patients as a group with mental health issues and on the construction of the health system as unable to provide health to noncitizens. Results are discussed in relation to current issues of social exclusion and the need to protect the human right of health.
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    The Cultural Adaptation of the Everyday Problems Test—Greek Version: An Instrument to Examine Everyday Functioning
    (Gerontology & Geriatric Medicine, 2021) Pavlidis G. ; Hatzifilalithis S. ; Marwan Zawaher N. ; Papaioannou G. ; Giagkousiklidou E. ; Vivas A.B.
    Assessing cognitive decline and everyday functioning (EvF) in older age is valuable in detecting age-related neurological disorders. In Greece, there is a lack of sensitive instruments that capture fluctuations in EvF among older persons who are cognitively healthy or have subtle cognitive impairments. The EPT 28-items test, a widely used paper-and-pencil EvF measure, was translated in Greek and adapted to the Greek culture in this study. A multi-step methodology using a sample of 139 older Greek persons was employed. The results indicate that the Greek version of the EPT 28-items (i.e., the EPT-G) was well adapted, representing everyday tasks in Greece within a good range of task difficulty. The psychometric properties of the EPT-G replicate those of the original instrument, capturing EvF fluctuations among older persons with mild cognitive impairments. It was concluded that the EPT-G is a useful measure of EvF among Greek older persons.
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    Emotional devaluation in ignoring and forgetting as a function of adolescent development
    (Cognition, 2021) Vivas A.B. ; Chrysochoou E. ; Marful A. ; Bajo T.
    We know that emotion and cognition interact to guide goal-directed behavior. Accordingly, it has recently been shown that distracting stimuli (Raymond, Fenske, & Tavassoli, 2003) and instructed to-be-forgotten items (Vivas, Marful, Panagiotidou, & Bajo, 2016) are emotionally devaluated. The devaluation by inhibition hypothesis (Raymond, Fenske, & Tavassoli, 2003) is the main theoretical explanation of these effects. However, we know little about how the cognition-emotion interplay is further modulated by development, and particularly, by changes in inhibitory control and affective processing within the adolescence period. In the present study we combined a selective attention task with faces, and a selective memory (directed forgetting paradigm) task with words, with a pleasantness evaluation task to address this question in three age groups; younger adolescents, older adolescents and young adults. Younger adolescents exhibited worse accuracy in the attention task, lower overall recognition of words in the memory task, and a smaller in magnitude directed forgetting effect in the latter, relative to the two older groups. That is, they showed less efficient inhibitory control in attention and memory selection. Despite this, all groups showed similar devaluation effects of the distractor faces and the to-be-forgotten words. Our findings do not fully support an inhibition account of such effects. Yet, they support the robustness of the forgetting devaluation effect, replicating the findings of Vivas, Marful, Panagiotidou, and Bajo (2016) with a Greek version of the task and in a bigger sample of participants.
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    Biculturalism, linguistic distance, and bilingual profile effects on the bilingual influence on cognition: A comprehensive multipopulation approach.
    ( 2021-04-15) Laketa, A ; Elisavet Chrysochoou ; Blakey, E. ; Vivas A.B.
    The idea that being bilingual benefits one’s cognitive development and performance has been greatly challenged over the last years. If such an effect exists, as some studies continue to show, it might actually be restricted to particular contexts and bilingual profiles; not unlikely, considering the enormous diversity in the latter across the world. In this study, we assessed 4 different bilingual populations (N = 201) and 2 monolingual populations (N = 105), in the Balkan region. We formed bilingual groups based on (a) acculturation strategy (bicultural vs. monocultural), (b) linguistic distance, as well as (c) bilingual profile (balanced vs. unbalanced), based on linguistic, affective, and acculturation measures and cluster analysis. Beyond prior work, this allowed us to explore the specific conditions under which any cognitive advantage may be observed in bilinguals. We did not find systematic evidence for positive effects of bilingualism, biculturalism, or a balanced bilingual profile on inhibitory control, cognitive flexibility, monitoring, and proactive-reactive control management. The only evidence pointing to an advantage was restricted to Bosnian-Albanian bilinguals (linguistic distance analyses) and their general monitoring capacity. Acculturation strategy though, played an important role in shaping the bilinguals’ language profile, and appeared to have independent effects on cognition from bilingualism. On this basis, acculturation should be considered in future explorations of bilingual cognitive development. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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    Emotional devaluation in ignoring and forgetting as a function of adolescent development
    (Elsevier, 2021-05-12) Vivas A.B. ; Chrysochoou E. ; Marful A. ; Bajo T.
    We know that emotion and cognition interact to guide goal-directed behavior. Accordingly, it has recently been shown that distracting stimuli (Raymond, Fenske, & Tavassoli, 2003) and instructed to-be-forgotten items (Vivas, Marful, Panagiotidou, & Bajo, 2016) are emotionally devaluated. The devaluation by inhibition hypothesis (Raymond, Fenske, & Tavassoli, 2003) is the main theoretical explanation of these effects. However, we know little about how the cognition-emotion interplay is further modulated by development, and particularly, by changes in inhibitory control and affective processing within the adolescence period. In the present study we combined a selective attention task with faces, and a selective memory (directed forgetting paradigm) task with words, with a pleasantness evaluation task to address this question in three age groups; younger adolescents, older adolescents and young adults. Younger adolescents exhibited worse accuracy in the attention task, lower overall recognition of words in the memory task, and a smaller in magnitude directed forgetting effect in the latter, relative to the two older groups. That is, they showed less efficient inhibitory control in attention and memory selection. Despite this, all groups showed similar devaluation effects of the distractor faces and the to-be-forgotten words. Our findings do not fully support an inhibition account of such effects. Yet, they support the robustness of the forgetting devaluation effect, replicating the findings of Vivas, Marful, Panagiotidou, and Bajo (2016) with a Greek version of the task and in a bigger sample of participants.
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    Higher Trait Levels of Guilt may Protect Against Gambling, Whereas Higher State Levels Lead to Riskier Behaviour
    (Springer Cham, 2021-06-03) Vivas A.B. ; Sotirios Stournaras ; P ; Paul G. Overton
    Research on the role of affect in problem gambling remains scarce to date, although it has been proposed that trait-levels of negative self-conscious emotions (SCEs) could be potential risk factors. We report two studies investigating the relationship between negative SCEs, gambling, and risky behavior. In the first study, we investigated shame, guilt and self-disgust in a group of problem-gamblers and control non-gamblers. In the second study, we investigated if experimentally manipulating state levels of guilt, using a narration-induction paradigm, in students with different levels of gambling behavior, would influence their behavior in the Balloon Analog Risk Task. We found that problem gamblers had significantly lower trait-levels of guilt when we adjusted for the influence of depression and anxiety symptoms (p = .008). Problem gamblers also exhibited lower levels of shame, but this difference seemed to be driven by guilt. Lower levels of guilt were significantly associated with higher levels of trait impulsivity (p = .004). In the second study, gamblers had higher state levels of guilt than non-gamblers at the outset, and the narration paradigm successfully induced guilt (p = .001). After the guilt induction, the group of gamblers had significantly less risky behaviour (lower number of pumps) than the group of non-gamblers (p = .021). However, this was primarily driven by an increase in risky behaviour in the non-gamblers (p = .006). Thus, overall our findings suggest that higher trait levels of guilt may act as a protective factor for gambling, whereas high state levels of guilt lead to riskier behaviour but only in people who are not gamblers.
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    Autonomic factors do not underlie the elevated self-disgust levels in Parkinson’s disease
    (PLOS ONE, 2021-09-02) Vasileia Aristotelidou ; Marianna Tsatali ; Paul G. Overton ; Vivas A.B.
    Introduction: Parkinson’s disease (PD) is manifested along with non-motor symptoms such as impairments in basic emotion regulation, recognition and expression. Yet, self-conscious emotion (SCEs) such as self-disgust, guilt and shame are under-investigated. Our previous research indicated that Parkinson patients have elevated levels of self-reported and induced self-disgust. However, the cause of that elevation–whether lower level biophysiological factors, or higher level cognitive factors, is unknown. Methods: To explore the former, we analysed Skin Conductance Response (SCR, measuring sympathetic activity) amplitude and high frequency Heart Rate Variability (HRV, measuring parasympathetic activity) across two emotion induction paradigms, one involving narrations of personal experiences of self-disgust, shame and guilt, and one targeting self-disgust selectively via images of the self. Both paradigms had a neutral condition. Results: Photo paradigm elicited significant changes in physiological responses in patients relative to controls—higher percentages of HRV in the high frequency range but lower SCR amplitudes, with patients to present lower responses compared to controls. In the narration paradigm, only guilt condition elicited significant SCR differences between groups. Conclusions: Consequently, lower level biophysiological factors are unlikely to cause elevated self-disgust levels in Parkinson’s disease, which by implication suggests that higher level cognitive factors may be responsible.
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    Pilot feasibility study of cognitive training exercises for Egyptian adults: Proof of concept
    (John Wiley & Sons Ltd, 2021-09-06) Heba M. Tawfik ; Marianna Tsatali ; Hany I Hassanin
    Objectives: Cognitive training exercises (CTE) are promising and effective interventions to enhance cognitive reserve and slowdown cognitive deterioration in people with subjective memory impairment (SCI) and mild cognitive impairment (MCI). In this pilot study, we aimed to assess the feasibility of CTE among Egyptian adults. Methods: Eighteen participants above 40 years old were recruited. They underwent baseline neuropsychological assessment and functional assessment. However, after receiving a 6 weeks' cognitive training, eight participants (seven with MCI and one was cognitively intact) dropped out from the study. Finally, 10 participants (8 participants with MCI, 1 with SCI and 1 was cognitively intact) completed 12 weeks of CTE and undergone the post-assessment afterward. CTE included visual, verbal, memory, executive function, visuospatial, attention, and psychokinetic exercises through onsite and home-based sessions. Results: For the 10 participants who completed 12 weeks of CTE, the Wilcoxon signed-rank test showed a statistically significant change in the scores of mini-mental state examination (Z = -2.546, p = 0.011), semantic fluency test (Z = -2.913, p = 0.004), subjective memory complaint questionnaire (Z = -2.913, p = 0.004), Consortium to Establish a Registry for Alzheimer's Disease Word List (first trial: Z = -2.641, p = 0.008; Word list recall: Z = -2.825, p = 0.005), construction abilities (immediate: Z = -2.121, p = 0.034; delayed recall: Z = -2.414, p = 0.016), and Digit span test (forward: Z = -2.724, p = 0.006; backward: Z = -2.724, p = 0.006). Conclusions: The results of this study suggested that CTE are feasible among Egyptian adults, especially those with MCI, and potentially effective in enhancing global cognition and after 12 weeks of training. Future research should shed light on the efficacy of longitudinal CTE implementation in Arab adults' populations.