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There is a lack of evidence of the health impacts due to long COVID among children and young people (CYP). The objective of this study is to determine the main clinical characteristics of long COVID in CYP and to investigate the academic, social, and health status impacts of long COVID in this population. An observational, descriptive, and longitudinal study on CYP who presented COVID-19 symptoms for more than twelve weeks after SARS-CoV-2 infection was performed between December 2020 and May 2021. Fifty CYP were included, with a median age of 14.1 years, 33 (66%) were female, and 17 (34%) had a relative diagnosed with long COVID. Since the initial infection and up to the first visit, CYP had persisting symptoms for a median of 4.1 months, and for 18 (36%) CYP these symptoms persisted for more than 6 months. Fatigue (100%), neurocognitive disorders (74%), muscular weakness (74%), and headache (72%) were the most reported symptoms. A total of 9 (18%) CYP could not attend school, 17 (34%) had a reduced schedule, 33 (66%) showed a decreased school performance, and 68% had stopped extracurricular activities. This preliminary study shows the impact that long COVID has on the health, academic, and social life of CYP.

Working memory is frequently impaired after traumatic brain injury (TBI). The present study aimed to investigate working memory deficits in patients with diffuse axonal injury and to determine the contribution of cerebral activation dysfunctions to them. Eighteen patients with severe TBI and 14 healthy controls matched for age and gender were included in the study. TBI patients were selected according to signs of diffuse axonal injury on computed tomography (CT) and without any evidence of focal lesions on MRI clinical examination. Functional magnetic resonance (fMRI) was used to assess brain activation during n-back tasks (0-, 2-, and 3-back). Compared to controls, the TBI group showed significant working memory impairment on the Digits Backwards (p = 0.022) and Letter-Number Sequencing subtests from the WAIS-III (p < 0.001) under the 2-back (p = 0.008) and 3-back (p = 0.017) conditions. Both groups engaged bilateral fronto-parietal regions known to be involved in working memory, although patients showed less cerebral activation than did controls. Decreased activation in TBI patients compared to controls was observed mainly in the right superior and middle frontal cortex. The correlation patterns differed between patients and controls: while the control group showed a negative correlation between performance and activation in prefrontal cortex (PFC), TBI patients presented a positive correlation in right parietal and left parahippocampus for the low and high working memory load, respectively. In conclusion, severe TBI patients with diffuse brain damage show a pattern of cerebral hypoactivation in the right middle and superior frontal regions during working memory tasks, and also present an impaired pattern of performance correlations.

Background Stroke patients usually suffer primary cognitive impairment related to attention, memory, and executive functions. This impairment causes a negative impact on the quality of life of patients and their families, and may be long term. Cognitive rehabilitation has been shown to be an effective way to treat cognitive impairment and should be continued after hospital discharge. Computerized cognitive rehabilitation can be performed at home using exercise programs that advance with predetermined course content, interval, and pace. We hypothesize that computerized rehabilitation might be improved if a program could customize course content and pace in response to patient-specific progress. The present pilot study is a randomized controlled double-blind crossover clinical trial aiming to study if chronic stroke patients with cognitive impairment could benefit from cognitive training through a customized tele-rehabilitation platform (“Guttmann, NeuroPersonalTrainer” ® , GNPT ® ). Methods/design Individuals with chronic-stage stroke will be recruited. Participants will be randomized to receive experimental intervention (customized tele-rehabilitation platform, GNPT ® ) or sham intervention (ictus.online), both with the same frequency and duration (five sessions per week over 6 weeks). After a washout period of 3 months, crossover will occur and participants from the GNPT ® condition will receive sham intervention, while participants originally from the sham intervention will receive GNPT ® . Patients will be assessed before and after receiving each treatment regimen with an exhaustive neuropsychological battery. Primary outcomes will include rating measures that assess attention difficulties, memory failures, and executive dysfunction for daily activities, as well as performance-based measures of attention, memory, and executive functions. Discussion Customized cognitive training could lead to better cognitive function in patients with chronic-stage stroke and improve their quality of life. Trial registration NCT03326349 . Registered 31 October 2017.

Objectives: How brain damage after stroke is related to specific clinical manifestation and recovery is incompletely understood. We studied cognitive reserve (CR) in stroke patients by two types of measurements: (i) objectively verifiable static proxies (i.e., education, occupational attainment), and (ii) subjective, dynamic proxies based on patient testimony in response to a questionnaire. We hypothesized that one or both of these types of CR measurements might correlate positively with patient cognitive performance during the post-acute and chronic phases of recovery. Method: Thirty-four stroke patients underwent neuropsychological assessment at 2, 6 and 24 months after stroke onset. In chronic stage at 24+ months, self-rating assessments of cognitive performance in daily life and social integration were obtained. CR before and after stroke was estimated using static proxies and dynamic proxies were obtained using the Cognitive Reserve Scale (CRS-Pre-stroke, CRS-Post-stroke). Results: CRS-Pre-stroke and CRS-Post-stroke showed significant mean differences. Dynamic proxies showed positive correlation with self-assessment of attention, metacognition, and functional ability in chronic stage. In contrast, significant correlations between static proxies and cognitive recovery were not found. Conclusions: Dynamic proxies of CR were positively correlated with patients’ perception of their functional abilities in daily life. To best guide cognitive prognosis and treatment, we propose that dynamic proxies of CR should be included in neuropsychological assessments of patients with brain damage.

Visuo-spatial neglect predicts longer hospitalization, poorer recovery of motor skills and greater functional limitation. The aim of the present study was to analyze whether the combined administration of computerized cognitive rehabilitation with right hemifield eye-patching in patients with left spatial neglect following a right hemisphere stroke is more effective than computerized cognitive rehabilitation applied in isolation. Randomized clinical trial conducted in 28 patients. These were grouped into two experimental groups: single treatment group (ST) (n= 15) and combined treatment group (CT) (n= 13). All received an average of 15 one-hour sessions of computerized cognitive rehabilitation using the Guttmann, NeuroPersonalTrainer® telerehabilitation platform. Those patients in the TC group performed the sessions wearing a visual device with which the right hemifield of each eye was occluded. Following treatment, both the ST and the TC group showed improvements in neuropsychological examination protocol although there were no differences pre- and post-treatment on the functional scale in either group. Likewise, no statistically significant differences were observed in intergroup comparison. The results from this study indicate that combination treatment is not more effective than rehabilitation applied in isolation.

Background: Visuo-spatial neglect predicts longer hospitalization, poorer recovery of motor skills and greater functional limitation. The aim of the present study was to analyze whether the combined administration of computerized cognitive rehabilitation with right hemifield eye-patching in patients with left spatial neglect following a right hemisphere stroke is more effective than computerized cognitive rehabilitation applied in isolation. Method: Randomized clinical trial conducted in 28 patients. These were grouped into two experimental groups: single treatment group (ST) (n= 15) and combined treatment group (CT) (n= 13). All received an average of 15 one-hour sessions of computerized cognitive rehabilitation using the Guttmann, NeuroPersonalTrainer® telerehabilitation platform. Those patients in the TC group performed the sessions wearing a visual device with which the right hemifield of each eye was occluded. Results: Following treatment, both the ST and the TC group showed improvements in neuropsychological examination protocol although there were no differences pre- and post-treatment on the functional scale in either group. Likewise, no statistically significant differences were observed in intergroup comparison. Conclusions: The results from this study indicate that combination treatment is not more effective than rehabilitation applied in isolation. Keywords: attention, stroke, spatial neglect, neuropsychology, cognitive rehabilitation, right hemifield eye-patching. Antecedentes: la negligencia visuo-espacial predice mayor tiempo de hospitalizacion, peor recuperacion de las habilidades motoras y limitaciones funcionales. El objetivo fue analizar si la administracion combinada de rehabilitacion cognitiva informatizada junto con el right hemifield eye patching, en participantes que presentan negligencia espacial izquierda como consecuencia de un ictus hemisferico derecho, es mas eficaz que la rehabilitacion cognitiva informatizada aplicada de forma aislada. Metodo: ensayo clinico aleatorizado realizado con 28 participantes. Dos grupos experimentales: grupo tratamiento unico (TU) (n= 15) y grupo tratamiento combinado (T C) (n= 13). Todos ellos recibieron una media de 15 sesiones de rehabilitacion cognitiva informatizada de una hora de duracion mediante la plataforma de telerehabilitacion Guttmann, NeuroPersonalTrainer®. Los participantes del grupo TC las ejecutaron con un dispositivo visual que llevaba el hemicampo derecho de cada ojo ocluido. Resultados: tras el tratamiento, tanto el grupo TU como el TC mostraron mejoras en el protocolo de exploracion neuropsicologica aunque no hubo diferencias pre- y post-tratamiento en la escala funcional en ninguno de los dos grupos. Asimismo, no se observaron diferencias estadisticamente significativas en la comparacion intergrupal. Conclusiones: los resultados derivados de este estudio indican que el tratamiento combinado no es mas eficaz que la rehabilitacion aplicada de forma aislada. Palabras clave: atencion, ictus, heminegligencia, neuropsicologia, rehabilitacion cognitiva, right hemifield eye-patching.

Objetivo: Realizar una revisión descriptiva sobre la heminegligencia visuo-espacial asociada a accidentes cerebro-vasculares. Se abordan los aspectos clínicos y teóricos más relevantes, así como las diferentes técnicas de intervención utilizadas actualmente. Desarrollo: La heminegligencia visuo-espacial es un déficit neuropsicológico multimodal asociado a lesiones cerebrales, principalmente de origen vascular. Su presencia implica una recuperación más lenta, mayor discapacidad y una respuesta precaria a la rehabilitación. Aunque la recuperación espontánea puede ocurrir en el transcurso de las primeras semanas o meses, el paso del tiempo no necesariamente implica una mejora de los síntomas. A día de hoy se han desarrollado múltiples estrategias de rehabilitación, pero son muy pocas las que demuestran efectos perdurables en el tiempo. Conclusiones: La adaptación de prismas es la técnica con la que se obtienen mejores resultados, aunque existen controversias respecto a sus beneficios a largo plazo. Las diferentes intervenciones que se describen en el artículo tienen un impacto transitorio y los resultados no acostumbran a traducirse en una mejora en las actividades de vida diaria. Las tendencias actuales apuestan por la aplicación combinada de diferentes técnicas.