Luigi Macchitella

Background: Time perception (TP) is increasingly recognized as a key cognitive domain in children and adolescents with cerebral palsy (CP), yet existing studies are scarce, heterogeneous, and methodologically limited. Objective: To synthesize empirical evidence on TP in pediatric CP, distinguishing perceptual timing deficits from motor-based impairments and outlining putative cognitive mechanisms. Methods: Following PRISMA where appropriate, we systematically searched Scopus, Embase, and PubMed Central for studies on TP in individuals with CP under 18 years. Four studies met inclusion criteria. Risk of bias was appraised with STROBE, AXIS, and RoB 2. Results: Available evidence suggests that TP difficulties in CP are not solely due to motor dysfunction but also reflect broader cognitive–perceptual challenges. Studies using low-motor-demand tasks sometimes report intact TP, whereas tasks requiring overt movement often confound perceptual timing with execution demands. Intervention findings are mixed: time-related supports show promising but inconsistent effects on everyday time processing, while motor-focused timing training demonstrates limited impact on TP itself. However, conclusions are constrained by the small number of studies and variability in samples, tasks, and outcomes. Conclusions: TP should be considered a distinct, clinically relevant construct in pediatric CP. Future work should employ motor-minimal paradigms, report standardized CP classifications, and adopt longitudinal designs to isolate TP deficits and guide targeted interventions. Clarifying TP profiles may improve cognitive characterization and rehabilitation planning in CP.

Background: The prevalence of individuals living with mild cognitive impairment (MCI), Alzheimer's disease (AD), and other forms of dementia is globally increasing. Four out of nine international clinical guidelines recommend non-pharmacological cognitive interventions to enhance cognition, independence, and wellbeing. However, the effectiveness of cognitive rehabilitation (CR) and cognitive training (CT) for individuals with MCI and AD and other forms of dementia is still debatable, often due to significant heterogeneity among studies. Objective: This study aims to assess the effectiveness of CT and CR in these populations. Methods: Following PRISMA guidelines, we conducted a comprehensive literature search across databases including OVID, MEDLINE, EMBASE, and Scopus, identifying randomized controlled trials and non-randomized pre-post intervention studies. The Bayesian meta-analysis focused on pre-post changes in global cognition, quality of life, everyday functioning, and depression, avoiding comparisons with control groups to reduce heterogeneity (PROSPERO: CRD42022365038). Results: The search yielded 6075 results, with 40 studies meeting inclusion criteria, encompassing 50 independent trials. CT and people with AD and other dementias are the best represented intervention and population, respectively. CT was more effective in improving global cognition in individuals with AD and other dementias, and paper-and-pencil and face-to-face formats yielded greater benefits. The analysis showed a significant susceptibility to bias among the studies. Conclusions: Limitations in outcome measure (e.g., MMSE) suggest the need for more sensitive assessments, especially for MCI. Future research should explore broader aspects of wellbeing and investigate the potential of CR. Policymakers are encouraged to consider these findings when designing cognitive interventions for this population.

In recent years, extended reality (XR) and telerehabilitation (TR) technologies have increasingly been used in the neurorehabilitation of motor dysfunctions in patients with cerebral palsy (CP). The Khymeia Virtual Reality Rehabilitation System (K-VRRS) is a medical device specifically designed for neuromotor rehabilitation, and it can also be used in TR mode. This pilot study aims to evaluate the effectiveness and adherence to a “two-step neuromotor program” (TS-NP) approach using K-VRRS to enhance upper limb motor functions in children with CP. The TS-NP protocol consists of two phases. In the first phase, patients undergo intensive motor training with K-VRRS during a period of hospitalization. In the second phase, initiated after discharge, patients continue K-VRRS treatment at home through TR, building upon the progress made during their hospital stay. A total of seven children with unilateral spastic CP (ages 4–10 years) were assessed at three time points: baseline (T0), after the first phase of in-person hospital treatment (T1), and following the second phase of TR treatment at home (T2). Standardized outcome measures were used, with the primary measure being the Melbourne Assessment 2. Preliminary data support the hypothesis that intensive K-VRRS treatment during hospitalization enhances motor function in the affected upper limb of children with CP. Furthermore, continuing K-VRRS treatment at home through TR appears crucial for maintaining the motor gains achieved during the hospital phase.

Obstructive sleep apnoea syndrome (OSAS) is a prevalent sleep‐related breathing disorder that has been extensively studied for its effects on cognitive functions. However, little attention has been given to investigating Mind Reading (MR) skills in patients with OSAS. In this study, we employed a neuropsychological approach to thoroughly assess various facets of MR skills in patients with OSAS. Forty‐two patients with untreated moderate or severe OSAS (AHI ≥15; 30 men, 12 women) and 16 healthy controls (7 men and 9 women), matched by age, were enrolled. To assess MR skills, we used: (i) The Story‐based Empathy Task (SET), which includes three experimental conditions: identifying intentions (SET‐IA), emotional states (SET‐EA), and a control condition for inferring causality reactions (SET‐CI); (ii) the Ekman 60 Faces Test (Ek60), which measures emotion recognition from facial expressions. Our findings revealed that patients with OSAS exhibit deficits in emotion‐related MR skills, while their ability to make inferences about the cognitive states of social partners remains largely preserved. This finding corroborates previous evidence indicating that social cognition, particularly MR skills, may be one of the cognitive domains affected by OSAS. It emphasizes the significance of investigating social cognition and the relationship between MR skills and social functioning as a new and intriguing area of research in patients with OSAS.

Sensory features of autism include hypo- or hyper-reactivity to pain; however, previous studies on pain in autism lead to conflicting results. Here, we present the state of the art and the methodological challenges concerning pain perception in autism, focusing on studies that used standardized protocol as Quantitative Sensory Testing (QST) to measure perception. Despite there are still scant evidences found with the use of QST, they have challenged the presumed hyposensitivity to pain in autisms, which emerged from parents’ reports. Both, peripheral and central mechanisms, have been found involved in typical features of perception in autism. Nonetheless, evidences with controlled protocols are still scarce, and even scarcer are studies focused on children. Overall, complex ethical challenges have to be overcome in order to collect subjective and objective measures from autistic children. With heterogeneous neurodevelopmental features, or intellectual disability, novel or modified protocols are needed.

Visuo-spatial working memory is one of the main domain-general cognitive mechanisms underlying mathematical abilities and their development in children. However, if visuo-spatial working memory involves different processes and components, then the term ‘mathematics’ refers to a broad concept that includes multiple domains and skills. The aim of this present study was to investigate the relationship between different visuo-spatial working memory components and several mathematical abilities in a sample of third- to fifth-grade Italian children. To assess the relationships between different visuo-spatial working memory components and different mathematical abilities, we relied on Network Analysis (NA). Results indicate that some but not all visuo-spatial working memory components are associated with some mathematical abilities.