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By Dr. Pablo Barrecheguren (@pjbarrecheguren)

Nowadays, the video game industry is one of the most important in the world, with a large part of the population consuming this type of product (e.g., 42% of the Spanish population) and generating worldwide sales of $108.9 billion in 2017. Given the magnitude of this industry, many researchers have wondered whether it would be possible to use video games for therapeutic purposes, and one of the best documented cases are studies on amblyopia.

Lazy eye problems

Amblyopia, commonly known as lazy eye, is one of the most common vision disorders in children. With a prevalence of approximately 2.4%, amblyopia affects about 15 million children worldwide. Amblyopia is a neurological condition since “the lazy eye” itself is structurally normal even though there is an imbalance that favors the use of one eye over the other in the part of the nervous system that controls the eyes. This results in vision problems and has a negative impact on quality of life since it may impede reading, delay the development of motor skills, and even reduce children’s self-esteem by affecting their personal image.

Eye patching

While this problem has been known for years, the gold-standard treatment for amblyopia has hardly changed in the last decades. This treatment entails covering the healthy eye with a patch thus forcing the use of the lazy eye. The underlying idea is that patching the stronger eye reinforces the nerve connections between the brain and the weaker eye to the point that the neurological imbalance between the two eyes disappears.

This is highly age-dependent since the older the patient, the less brain plasticity. Four-year-old patients had to patch for on average 170 hours, for around 236 hours to achieve a similar effect in patients aged between five and six, and for more than 400 hours those over seven years of age.

To this excessive number of hours must be added the discomfort and vision loss suffered by the child during the treatment; moreover, since these are neuroplastic processes it is possible for improvements to be reversed once the treatment has ended (approximately 25% of patients experience a recurrence during their first year off treatment).

Video games to improve visual perception

In this regard, there is a growing scientific literature indicating that playing certain types of video games can improve several aspects of visual perception in adults. Specifically, first-person shooter video games (such as the Call of Duty series, Battlefield or the popular eSport Overwatch) seem to have this effect, while in other genres such as simulation video games or puzzle games such as Tetris these effects have not been observed.

The idea of using video games as therapy to reorganize the connections of the visual nervous system has a lot of potential since video games are a very attractive product for small children and one of the problems that faces the treatment of amblyopia is its duration and that it is extremely uncomfortable, so the collaboration of the patient is often limited and this could be solved with the gamification of treatment. In addition, if training through video games is an effective approach, the hundreds of hours of current treatment may not be necessary to cure amblyopia.

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Study using the video game The Magical Garden

A recent study made twenty-one patients with unilateral amblyopia complete a total of twenty hours of the Magical Garden, a first-person video game created with the graphics engine of the popular first-person shooter game Unreal Tournament, though all violent content from the original was removed. Participants just had to move around the settings, collect objects and point to moving objects like robots that appeared on screen. Playing this action video game resulted in improved visual abilities and participants’ improvements were largely retained 6-10 weeks after the completion of training. This study has paved the way to a potential therapeutic use of video games to treat neurological problems.

References
  • Fronius, M., Cirina, L., Ackermann, H., Kohnen, T., & Diehl, C. M. (2014). Efficiency of electronically monitored amblyopia treatment between 5 and 16 years of age: New insight into declining susceptibility of the visual system. Vision Research, 103,11–19.
  • Gambacorta, C., Nahum, M., Vedamurthy, I., Bayliss, J., Jordan, J., Bavelier, D., & Levi, D. M. (2018). An action video game for the treatment of amblyopia in children: A feasibility study. Vision Research, 148 (March 2018), 1–14.
  • Green, C. S., Li, R., & Bavelier, D. (2010). Perceptual learning during action video games. TopicS. Special Issue on Perceptual Learning, 2(2), 202–216.
  • Lee, H. J., Tran, D. D., & Morrell, H. E. R. (2018). Smoking, ADHD, and Problematic Video Game Use: A Structural Modeling Approach. Cyberpsychology, Behavior, and Social Networking, 21(5), 281–286.
  • Tetik, B. K., Kayhan, D., Sertkaya, S., & Sandikci, K. B. (2018). Evaluation of the effects of digital play addiction on eating attitudes. Pakistan Journal of Medical Sciences, 34(2), 482–486.
  • Wu, C., & Hunter, D. G. (2006). Amblyopia: Diagnostic and therapeutic options. American Journal of Ophthalmology, 141(1), 175–184.

If you liked this article written by Pablo Barrecheguren, PhD in Biomedicine, you might find his following articles interesting as well:

La entrada Video games help treat neurological problems: a pioneering example for combating lazy eye aparece primero en NeuronUP - Cognitive Rehab Software - Cognitive Rehabilitation Exercises, News for occupational therapists, Neuropsychology information and advice.

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NeuronUP and Yetitablet join forces to advance neurorehabilitation. Our cognitive stimulation platform has found the perfect ally to provide quality cognitive rehabilitation in this Finnish startup that specializes in the manufacturing of tablets.

What is a Yetitablet?

The Yetitablet is an intuitive, versatile and high-performance giant tablet created by Maria and Jarkko Jokelainen, co-founders of the Finnish company Kuori. The couple are parents of 3 children with Asperger’s who struggled for years to help their children learn and communicate with the world. In 2015, they came to notice that interactive lessons in multimedia classrooms played a crucial role in helping their children learn, focus and communicate better, and they took on the challenge of creating the Yetitablet.

Today, the Yetitablet has become more than an educational tool. It can be used in different industries including business, transportation, tourism, construction, education, and healthcare.

“Developing the Yetitablet is a way for us to help our autistic children connect with the world. More than a business, it’s a personal mission that we have to do.”

Maria and Jarkko Jokelainen

+Information about the Yetitablet

NeuronUP and Yetitablet

The therapist Bea de Juan, who works at the Centro San Rafael of the Fundación Francisco de Borja, tells us about her experience using NeuronUP on the Yetitablet:

NeuronUP x Yetitablet - YouTube

“The size of the tablets and the fact that clients can use them while standing up greatly favors their independence,” says Bea de Juan.

“Using NeuronUP on these devices is much better,” says the therapist.

NeuronUP and Yetitablet, together in conferences

The two companies have now been collaborating for several months. We have presented NeuronUP with the help of these devices at several conferences, meetings, and events:

La entrada NeuronUP and Yetitablet join forces to advance neurorehabilitation aparece primero en NeuronUP - Cognitive Rehab Software - Cognitive Rehabilitation Exercises, News for occupational therapists, Neuropsychology information and advice.

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By Dr. Pablo Barrecheguren (@pjbarrecheguren)

Of the five senses, smelling is perhaps the least valued nowadays, even when we all have strong emotional memories associated with some odor. For example, we all remember our grandparents’ houses and their distinct smell. Japanese culture has its own term for this smell, kareishu or “old people smell,” and science has discovered that the substance 2-nonenal found in human body odor tends to increase with aging.

This is particularly interesting because it means that, regardless of our level of hygiene, our body odor changes as we age, which leads to a thought-provoking clinical question: can specific smells be linked to certain diseases? Several researchers are working on this matter and, among other things, they have found that trained dogs could accurately (91%) distinguish between the breath of people with and without colon cancer. This opens the door to the search for odorous molecules associated with certain illnesses.

Joy Milne can smell Parkinson’s disease

In this regard, one of the most researched fields is that of Parkinson’s disease and all thanks to one woman: Joy Milne. Joy’s husband suffered from Parkinson’s and while attending a research lecture at the University of Edinburgh, she asked the speaker if people with Parkinson’s had a characteristic smell. This anecdote led to two discoveries: first, just like great sommeliers, Joy had an extraordinary sense of smell that was well above average. Second, Joy was able, by scent alone, to identify if study participants had the smell that her husband had developed and therefore to know if they had Parkinson’s disease or not.

This revelation led to a research study where she identified people with Parkinson’s by smelling t-shirts they had worn (six worn by people with Parkinson’s disease and six by healthy individuals). Her sense of smell was such that she was correct in 11 of the 12 people, incorrectly identifying one of the healthy people as having Parkinson’s disease. Few months later, however, that person was diagnosed with Parkinson’s, so Milne turned out to be correct even ahead of the clinical diagnosis; in fact, she stated that her husband began to have that unique odor six years before he was diagnosed with the disease.

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After this first study, Joy continued to collaborate with the researchers. Little by little, they discovered that the origin of the scent was in the sebum, the skin fat, which is interesting because dermatological problems have already been documented in patients with Parkinson’s disease. Current research focuses on isolating the molecules responsible for this almost imperceptible odor: although work is still in progress, it is known that people with the disease have altered levels of certain metabolites in their sebum (e.g., perillaldehyde and eicosane), the smell described by Joy Milne as being very similar to the scent developed by her husband.

Apart from being very curious, these research studies have great potential; currently Parkinson’s is only diagnosed once the symptoms appear and these are usually detected when approximately 60% of the neurodegeneration causing the disease has already occurred. In other words, doctors rarely diagnose Parkinson’s disease in the early stage, so treatment starts late, and it is difficult to stop the neurodegeneration in time. Current treatments can relieve symptoms for much of the patient’s remaining life (15-year average) but the situation would surely be better if doctors could detect the disease earlier.

And this is where Joy and scents come in: if it is confirmed that patients have different levels of certain molecules in the skin even before Parkinson’s symptoms manifest themselves—even though the average person cannot detect the smell (almost no one has Joy’s sense of smell)—it would then be possible to take a sample of this skin fat, analyze it and see if a person has the disease or not. Thus, even when it is still under study, it is possible that something as subtle as odor could have a huge impact on Parkinson’s research.

References
  • Abellán, A. “¿Sabías que a los treinta años comienzas a oler a viejo?”. Principia Magazine.
  • Morgan, J. (2016). Joy of super smeller: sebum clues for PD diagnostics. The Lancet Neurology, 15(2), 138–139.
  • Sonoda, H., Kohnoe, S., Yamazato, T., Satoh, Y., Morizono, G., Shikata, K., … Maehara, Y. (2011). Colorectal cancer screening with odour material by canine scent detection. Gut, 60(6), 814–819.
  • “’Super-smeller’ helps develop swab test for Parkinson’s disease”. The Guardian.
  • Trivedi, D. K., Sinclair, E., Xu, Y., Sarkar, D., Walton-Doyle, C., Liscio, C., … Barran, P. (2019). Discovery of Volatile Biomarkers of Parkinson’s Disease from Sebum. ACS Central Science.

If you liked this article written by Pablo Barrecheguren, you might find  the following interesting as well:

La entrada Parkinson’s smell aparece primero en NeuronUP - Cognitive Rehab Software - Cognitive Rehabilitation Exercises, News for occupational therapists, Neuropsychology information and advice.

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Information on the free online presentation

Title of the conference: “Clinical Application of Evidence-Based Cognitive Rehab. Considerations Based on Impairment Severity and Treatment Setting.”

Date: Monday, May 6, 2019
Timetable:

  • San Francisco: 1:00 p.m.
  • New York: 4:00 p.m.
  • London: 9:00 p.m.
  • Sydney: 6:00 a.m. (Tuesday, May 07)

SIGN UP FOR PRESENTATION

“Clinical Application of Evidence-Based Cognitive Rehabilitation Strategies: Considerations Based on Impairment Severity and Treatment Setting.”

Amy Rosenbaum

Director of the Traumatic Brain Injury Rehabilitation Program at Park Terrace Care Center.

Dr. Rosenbaum received her doctorate in clinical and school psychology from Hofstra University, and has specialized in the field of brain injury rehabilitation for almost 20 years.

She is responsible for directing interdisciplinary treatment planning, overseeing program planning and development, as well as all TBI-related staff education and training.She was integrally involved in creating the center’s cognitive rehabilitation, coma recovery and coma management programs, and remains responsible for the clinical oversight of these programs.

Dr. Rosenbaum also serves as a TBI model systems investigator for the NY TBI Model System at Mt. Sinai.Her clinical and research interests include disorders of consciousness, post-traumatic confusional disorders, cognitive rehabilitation, evidence-based practice, neuropsychological assessment, and psychotherapy after brain injury. She has published in textbooks and peer reviewed journals; her work has been presented both nationally and internationally.She is the current Co-Chair of the ACRM BI-ISIG Cognitive Rehabilitation Task Force, ACRM Cognitive Rehabilitation Manual Faculty, and Chair of the Public Awareness and Advocacy Workgroup of the Joint NIDRR and ACRM BI-ISIG Disorders of Consciousness Task Force.

She is also an author of ACRM’s “Cognitive Rehabilitation Manual: Translating Evidence-Based Recommendations into Practice” and is the managing co-editor for the upcoming second edition manual and textbook.

Keith Ganci

Licensed clinical psychologist specializing in neuropsychology and brain injury rehabilitation.

Dr Ganci received his Ph.D. in clinical psychology in 2011 from Fairleigh Dickinson University. He completed his clinical internship at the NYU Rusk Institute of Rehabilitation Medicine and a two-year APPIC accredited neuropsychology postdoctoral fellowship at the JFK-Johnson Rehabilitation Institute

He is an active member of the North Carolina and New Jersey State Psychological Associations. He is also an active member of The American Congress of Rehabilitation Medicine’s (ACRM) Cognitive Rehabilitation and Sports Rehabilitation Task Forces, is on the ARCM Cognitive Rehabilitation Manual and Training Faculty and will be one of the primary authors on the upcoming ARCM second edition manual and textbook.

He was awarded the ACRM Early Career Scholarship in 2013 and 2014. He was also recently appointed to the Brain Injury Association of America’s (BIAA) Cognitive Issues Panel to create best-practice-guidelines for the rehabilitation of moderate to severe traumatic brain injury.



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What is NeuronUP Academy?

The platform of neurorehabilitation NeuronUP ,launches NeuronUP Academy, a training academy geared towards professionals working in rehabilitation and cognitive stimulation.
This initiative was born with the idea that neurorehabilitation professionals expand their knowledge by attending free training provided by national and international authorities in the field of rehabilitation and cognitive stimulation.
This online academy is open to all occupational therapists, clinical psychologists, speech language therapy professionals and students working and studying in  processes of rehabilitation and cognitive stimulation and there will be exclusive training for NeuronUP users.

Learn how to use NeuronUP

Sign up to our free online course

Confirmed speakers for NeuronUP Academy 2019 include:
  • Sarah Raskin
  • Amy Rosenbaum
  • Keith Ganci
  • Kristine Kingsley
  • Stephanie Kolakowsky-Hayner
  • Gabriela Cantarero
  • Alicia Fernández-Zúñiga
  • More to be announced soon!

We are sure their presentations will be very interesting!

If you want to know more about NeuronUP Academy speakers, visit the following link:

https://blog.neuronup.com/en/neuronup-academy-neurorehabilitation/

La entrada Dual presentation – Dr. Amy Rosenbaum and Dr. Keith Ganci aparece primero en NeuronUP - Cognitive Rehab Software - Cognitive Rehabilitation Exercises, News for occupational therapists, Neuropsychology information and advice.

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A cognitive stimulation therapy (CST) session will be conducted in a group of 15 people with mild cognitive impairment (MCI) and without cognitive impairment using the NeuronUP platform.

General objective

Restoring clients’ impaired cognitive functions and, once recovered, preserving those that have been regained.

Specific objectives

The Occupational Therapy Practice Framework (AOTA) (2) will be used to carry out this intervention.

The intervention approaches that will be used to achieve the desired outcomes are: restoration (restore the clients’ skills that have been impaired) and maintenance (to provide the supports that will allow clients to preserve the capabilities they have regained) (2).

The type of activities will be based on several areas of occupation:

  • Instrumental activities of daily living (IADLs)
  • Education (environment)
  • Play
  • Social participation (since it is a group intervention) (2).

In addition, three types of activities will be carried out:

  • Fun activities that clients may like such as a “Card pyramid” and “Word search”, which will be addressed below.
  • Other activities to help clients integrate new concepts into their lives (e.g., “Pick up your luggage” and “Recycle your trash”).
  • Activities related to concepts (e.g., “Word association” and “Emotion recognition”).

The activities can be adjusted to clients’ pace of work; in addition, they are short so clients do not lose focus or become tired and discouraged. Finally, it should be noted that clients will be encouraged and helped during each activity.

Activities Moving colors

This activity consists of finding, as quickly as possible, the squares that remain still among a group of squares that are in constant motion.

Clients have three lives, losing one life every 3 mistakes until they run out of them. The activity ends when the client identifies the squares that are not moving and clicks on them. Stage 4 has been chosen as the starting point for this intervention: if clients make no mistakes, they will be prompted to move to the next stage; if they make mistakes, they will go back to the previous stage.

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Pick up your luggage

In this activity, participants must select, among the suitcases coming out on the luggage carousel, only the suitcases that are identical as the one(s) shown in the model (with the same characteristics). Depending on the stage, more model suitcases will be presented. In this case, clients will start in stage 7, so they will have to select those suitcases that are identical to the two given as models. Clients must pay close attention to the features as very similar suitcases may appear.

As in the previous activity, clients have three lives. Each time they lose a life, the model suitcases change and the suitcases on the luggage carousel change as well. The activity will end when clients have selected all the suitcases coming out on the carousel that match those shown in the model, that is, those with identical features.

Word search

This activity involves finding all the words hidden in a grid. Words can be located horizontally, vertically, or diagonally and they can be found in any direction.

Clients can choose between three game modes: correction mode, meaning that if clients make a mistake and it’s not the word they had to find, then it’s marked as incorrect; or free mode, when clients get to know at the end of the activity if they did it correctly or if they didn’t.

A third game mode is a personalized mode. In this mode, the game can be modified according to the client by selecting either the correction or the free mode as well the maximum number of errors. The maximum time to complete the activity can also be modified by choosing how many minutes the client can spend on the activity. Similarly, it is possible to include an inactivity warning so that if clients spend, for example, one minute without finding a word, they will be prompted to continue the game, as they may have been distracted; the warning will be visual and auditory. A timer counting down or upwards can also be selected so that clients can see the time remaining to complete the activity. Finally, it is possible to give specific instructions to make the task easier for the client (e.g., to create a customized word search with the names of the client’s grandchildren, which will be found in the box).

The settings that can be adjusted to increase or decrease the difficulty are: the size of the grid (columns and rows can be removed or added), the direction in which the words are placed (horizontal, vertical, diagonal or even backwards), the number of words to be found and finally, what words the therapist wants the client to find, sorted by word length, subject or, as mentioned above, a customized word search (e.g., name of client’s grandchildren).

Emotion recognition

This activity involves recognizing the emotions depicted and matching them to their definition. There are three levels of difficulty: once the level has been selected, the task starts: the participant must look at the image of a person whose facial expression depicts a specific emotion and match it to its definition. The client must click on the word he believes matches the emotion from the depicted facial expression, as seen below.

A medium difficulty level will be selected in this case since it is not highly complex. At this level, it is possible to select one of the 11 sub-levels. If participants see that they can increase the difficulty, there is the possibility of selecting another level of greater difficulty with its corresponding sub-levels. Click on “correction mode” to start playing (that way participants receive positive feedback regarding their choices). Clients only have one life in each level.

Word association

This activity is aimed at improving executive functions. It involves matching words that are associated to each other. These words are placed in three different columns. This activity has three levels of difficulty and multiple sub-levels depending on the chosen level of difficulty.

Participants select a medium difficulty level and the correction mode (to check whether their answers are right). They have three lives. If participants feel they can improve their performance in terms of difficulty, they can move up a stage to increase the complexity.

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Recycle your trash

This activity consists of placing different types of waste in their corresponding recycling containers.

This activity relates to activities of daily living (ADLs), more specifically to instrumental activities of daily living (IADLs), as it deals with issues related to cooking, cleaning, and environmental education.

Clients must complete four exercises. They have a maximum time of 4 minutes to do so.

The game will display an inactivity warning after 2 minutes. To manage time better, a timer counting upwards will be displayed on the left top side of the screen. The activity’s description will be as clear as possible to help clients understand it.

The difficulty level increases as the exercises are completed. Therefore, clients should start with those displaying a house scenario with a total of 4 items to be placed in different containers and should be allowed a high number of errors.

Card pyramid

This activity consists of arranging the cards that are presented in either ascending or descending numerical order (suits do not matter). Spanish playing cards are numbered from “as” (ace) to 7, then the “sota” (jack), “caballo” (knight), and “rey” (king). This activity concerns play (one of the areas of occupation).

Participants must pass 5 exercises. They have a maximum time of 5 minutes to do so. The game will display an inactivity warning after 2 minutes. To manage time better, a timer counting upwards will be displayed at the left top side of the screen. The activity’s instruction will be as clear as possible to help clients understand it. As clients move up, the difficulty level increases, thus increasing the number of rows and columns, the number of decks, the correction criteria, and the number of errors. Additionally, the time limit to complete the activity will be progressively reduced.

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Bibliography
  • NeuronUP. NeuronUP [sede Web]. La Rioja: Neuronup; 2012 [acceso el 15 de noviembre de 2018]. Disponible en: https://www.neuronup.com/en
  • Ávila Álvarez A, Máximo Bocanegra M, Martínez Piédrola R, Matilla Mora R, Méndez Méndez B, Talavera Valverde MA et al. Marco de trabajo para la práctica de la Terapia Ocupacional: dominio y proceso. 2da Edición [Traducción]. www.terapia-ocupacional.com [portal en Internet]. 2010 [consultado el 20 de noviembre de 2017]; [85p.]. Disponible en: http://www.terapiaocupacional.com/aota2010esp.pdf. Traducido de: American Occupational Therapy Association (2008). Occupational therapy practice framework: Domain and process (2nd ed.).

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Emotional intelligence is a basic concept in psychology that is gaining in importance. It is considered crucial in predicting our health and happiness since it is closely linked to handling various life situations intelligently. In addition, it is essential to train emotional intelligence for stress, anxiety and other mental disorders.

Emotions have a major influence on the decisions we make in life, even those made about seemingly rational issues. In fact, research suggests that 95% of all our decisions are influenced by our emotions (Arrabal Martín, 2018).

Although these decisions may not seem to be very wise at first glance, research shows that people with high emotional intelligence can make better decisions than those with high IQs. Studies point to many successful individuals whose emotional intelligence is far superior than their cognitive intelligence.

In short, learning how to increase your emotional intelligence is essential for leading a fulfilling and healthy life, and building good relationships with those around you

Initial conception of emotional intelligence

The concept of emotional intelligence is relatively new, first appearing in Gardner’s theory of multiple intelligences. This author was the first to reformulate the concept of intelligence, breaking with previously established conceptions. Thus, Gardner originally proposed that individuals possessed seven intelligences quite independent of each other. Among these, he described intrapersonal intelligence and interpersonal intelligence, aspects that had not previously been taken into consideration when defining intelligence.

However, emotional intelligence as such was formally defined by Salovey and Mayer in 1990 based on Gardner’s proposal.

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Daniel Goleman’s Emotional Intelligence

However, it was Daniel Goleman who popularized the concept thanks to his work Emotional Intelligence, one of today’s best-selling books.

Goleman is considered the most prominent psychologist in the revolutionary idea of emotional intelligence. His ideas generate a growing interest among different fields as he states that emotional intelligence can be the key to success in life without relying on the “traditional” IQ. Moreover, he considers this type of intelligence to be the most powerful tool we have when making life decisions and to matter far more than IQ.

In a later book, Goleman broadened the concept by applying emotional intelligence to the workplace and leadership.

Additionally, it is worth noting that, despite being a subject primarily researched by cognitive psychology, there are studies that reveal the biological basis of emotional intelligence. For example, LeDoux shows that the amygdala connects the so-called “rational brain” and the “emotional brain.” This allows us to modify our emotions according to the context and environmental demands.

What is emotional intelligence?

The definition of emotional intelligence arose from the need to answer the question of why there are people who adapt better than others to different everyday situations. The secret to success seems to lie in emotional intelligence, which can be defined as the ability to identify, understand and manage emotions in oneself and others.

Specifically, Goleman defines it as the “ability to recognize, accept, and channel our own emotions, to guide behavior to achieve desired goals and to share them with others.”

What do we mean by emotional intelligence?

Emotionally intelligent individuals can discriminate between emotions, accept them and manage them efficiently to be successful in life. This helps them achieve their goals and build better relationships with themselves and others.

As you may have noticed, emotional intelligence is made up of the following key attributes:

  • The ability to recognize your own emotions (self-awareness).
  • The ability to regulate and manage your emotions (self-regulation).
  • Motivation
  • The ability to understand the emotions of others (empathy).
  • The ability to build positive relationships (social skills).

Thus, people with high emotional intelligence should possess these qualities and use them as tools to achieve success in different areas of their lives.

Examples of emotional intelligence

Some examples are:

  • Being able to actively listen to others without any interruptions and paying attention to their nonverbal language.
  • Becoming aware of our own emotions and how we manage them (or whether we avoid them).
  • Responding appropriately to others’ emotions, such as crying or anger outbursts.
  • Regulating emotions which might be socially inappropriate or counterproductive for the situation.
  • Seeking win-win solutions to resolve conflicts.
How to measure emotional intelligence?

Professionals should measure emotional intelligence with tests that meet psychometric standards. There are three types of methods to do so:

  • Self-report: participants complete the test by themselves and rate the extent to which they agree or disagree with each statement (e.g., the Schutte Self-Report Emotional Intelligence Test or SSEIT).
  • Other-report: this method is used with groups of people who interact frequently with each other (e.g., co-workers or employees). Each person should assess the level of emotional intelligence of each group member (360-degree feedback assessment). It may represent a somewhat subjective and biased view since people tend to include personality traits, mistakenly considering them as emotional intelligence traits.
  • Ability measures: ability tests are a more reliable measure and are based on emotional intelligence skills (e.g., the Multifactor Emotional Intelligence Scale or MEIS, or its improved version, the Mayer-Salovey-Caruso Emotional Intelligence Test or MSCEIT).

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How to develop emotional intelligence?

Emotional intelligence can be acquired through emotional learning. This learning process is aimed at acquiring “the set of knowledge, skills, abilities and attitudes necessary to understand, express and regulate emotional phenomena appropriately” (Bisquerra and Pérez, 2007).

To develop emotional intelligence, first and foremost, it is fundamental to work on our ability to perceive, describe and express our affective states and those of others. Identifying our emotions helps guide our thoughts and behaviors so as to motivate ourselves and set and achieve goals in life.

Many times, we are unable to put our feelings into words, or we label our emotions in a very basic manner (e.g., I am “fine” or “not fine”) when could be more precise just by trying a little harder (e.g., I feel surprised, disappointed, liberated, etc.). The goals at this point should be to recognize your emotions and know what they mean, in addition to understanding these emotions, distinguishing between them, and learning how they evolve.

The next level is emotional regulation, that is, controlling both positive and negative emotions properly.

Afterwards, you can then start working on identifying emotions in others. This is essential to build positive social relationships.

The ability to understand others, i.e. empathy, should then be enhanced. It is therefore crucial not only to pay attention to what other people say but also to observe their non-verbal communication to integrate all the information.

The ability to regulate other people’s emotions is also trained. This is achieved mainly through emotional communication and active listening. By working on all these aspects, you will gradually increase your emotional intelligence.

Emotional intelligence activities

If you would like to learn how to improve your emotional intelligence, here are some activities to help you start right away.

Pay attention to your emotions

You should write in detail the feelings of your last few days before going to bed. You can start out with yesterday and try to go back as far as possible. Also, try to connect these emotions with what happened to you throughout the day. Try not to confuse your emotional states (sad) with physical states (tired).

Another approach to being aware of past emotions is to describe how you felt at three important events of your childhood. Try to describe both positive and negative events. You can also do this with emotions from the recent past (last three years, for example).

Name your emotions

Writing about your emotions and reflecting on their origins and consequences leads to a better understanding of our emotional intelligence.

Schedule a time each day to pause and write down what you are feeling at that moment. You can set an alarm so you don’t forget and make it a habit. Try to reflect on and include as much information as you can. It can be very useful to use Robert Plutchik’s wheel of emotions.

A version of the exercise is to select a poem and analyze the emotions you experience while reading it. It is not about describing what the author intended to express but what he made you feel. Choose about six words to describe how you feel, including physical sensations. You can do the same with pictures, movies or videos.

REQUEST A DEMO Regulate your emotions

To become more aware of how you regulate your emotions, you can write down what you do and what you think when you are in a certain affective state. For example, you can start by analyzing how you react to fear, then to sadness, and finally to anger. To facilitate the task, imagine and visualize yourself in that situation and pay attention to what you think, what you do, and whether or not you try to avoid your feelings.

You can do the same exercise but describing instead your reaction to a pleasant experience, for example, some positive comment you may have received.

Identify other’s emotions

The most common activity for practicing this aspect of emotional intelligence is to look at photographs or watch videos of different facial expressions and describe in detail the emotions they convey. Are they positive, negative or inexpressive? What is the position of the mouth or eyebrows? Do they indicate closeness or avoidance? Keep the context in mind!

Practice active listening

This is a group activity performed with the help of a moderator. It involves choosing a discussion topic—start with basic topics and then move on to more complex ones. Each person must give their opinion on the subject and it is essential that, before speaking, they summarize the last person’s opinion.

The mirror

This exercise should be done in pairs. One of you should speak honestly and naturally about an important life situation. The other person should listen actively and pay attention to their partner’s non-verbal signals since, afterwards, he/she will have to “imitate” his/her partner as faithfully as possible. You should try to reproduce the tone of voice, gestures, pauses, etc.

Emotional intelligence in children

Emotional intelligence is not just for adults; in fact, it is recommended to start emotional learning from the early years of school. Ideally, all schools should have an emotional learning program involving teachers, family members, and students.

However, emotional intelligence should not be missing in the home as well. Parents should encourage emotionally intelligent role models and, to that end, they first must develop their own emotional intelligence.

Helping children develop their emotional skills at an early stage has been shown to enhance long-term health and well-being outcomes. In addition, emotional intelligence also helps people to avoid substance abuse, violence, impulsivity behavior, delinquency, etc. while promoting academic and professional development and helping to reduce stress and depression.

References
  • Arrabal Martín, E. M. (2018). Inteligencia Emocional. Editorial Elearning, SL.
  • Bisquerra Alzina, R., & Pérez Escoda, N. (2007). Las competencias emocionales.  Educación XXI: revista de la Facultad de Educación (10), 61-82.
  • Fernández Berrocal, P. y Ramos Díaz N. (2016). Desarrolla tu inteligencia emocional. Barcelona: Editorial Kairós.
  • Gallego Matellán, M. (2015). Educación emocional con y sin TDAH. Madrid: EOS.
  • García Navarro, E., López-Cassà, E., Pérez-González, J. C., Lantieri, I., Nambiar, M., Aguilera, P., … & Planells, O. (2012). ¿Cómo educar las emociones? La inteligencia emocional en la infancia y la adolescencia. Esplugues de Llobregat (Barcelona) Hospital Sant Joan de Déu.
  • Grewal, D., & Salovey, P. (2006). Inteligencia emocional. Mente y cerebro, 16(1), 10-20.
  • Trujillo Flores, M. M., & Rivas Tovar, L. A. (2005). Orígenes, evolución y modelos de inteligencia emocional. Innovar, 15(25), 9-24.

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NeuronUP has cognitive stimulation exercises to train the cognitive functions most frequently affected in people with Parkinson’s disease: attention, visuospatial skills, information processing speed and, especially, executive function.

Cognitive Stimulation Activities for People with Parkinson’s Disease
  1. Task Sequencing (text-only)

This kind of activity is very useful for the stimulation of executive function in people with Parkinson’s disease.  All daily activities can be divided into steps that the person must complete in order.

For example, in the image above, the person must number the steps necessary to make a meal in a logical order. This activity includes both picture-only and text-only versions.

  1. Knitting a Scarf

In this activity, clients must control a scarf which roams around picking up the balls of yarn, while trying to avoid hitting its own tail or the walls that surround the playing area. This exercise is an excellent choice for training visuospatial skills, sustained attention, and processing speed.

  1. Word Association

“Word association” is another classic in cognitive stimulation, and is ideal for people with Parkinson’s disease. This exercise is oriented towards training language, reasoning, and semantic memory. In this example, clients must match words that are associated to each other. Another alternative is to match pictures.

  1. Intertwined

A more suitable activity for people with mild to moderate Parkinson’s disease, and very effective for stimulating visuospatial skills, this exercise involves forming a geometric figure by moving its vertices into shape without its sides crossing each other.

  1. Word Search

Another mental activity that is a classic in cognitive stimulation is ‘word search’. It involves finding hidden words within a word search puzzle, and it is excellent for people with Parkinson’s disease to promote attention. This activity has many versions: finding certain fruits in the grid of letters, finding single-colored words or specific symbols, etc.

NeuronUP provides a customized word search in which the words can be adapted to the individual needs of each person. For example, the therapist can create a customized word search with the client’s favorite players or the names of their relatives, which is something ideal to improve the client’s motivation while completing the puzzle.

  1. Matching Pairs by Category

The idea here is to match pairs of words by category, for example, a pair of clothing items. This activity especially targets reasoning.

  1. Find the Monument

An activity that we all possibly end up doing since it is so motivating, this exercise consists of following the directions as quickly as possible until finding the monument within a set time. It definitely stimulates processing speed in particular.

There are manylternatives: just by putting a time limit on an appealing activity and with a clearly quantifiable purpose, we have an exercise to stimulate cognitive processing speed.

  1. Moving Cubes                                                                     

This activity consists of visualizing what a series of cubes would look like if some of them were moved. This task is designed for patients with mild to moderate Parkinson’s disease. Spatial visualization and planning are particularly trained.

  1. One-way Journey

With this type of exercise, we can train visuospatial skills. First, we make sure that the people in the group are familiar with the city where they live, and then, we select two well-known places that they must travel mentally as if they were walking to them.

The origin may, for example, be their home, and a movie theater could be their destination. Which streets do they have to take? Even if the level of motor impairment of the patients is not very advanced, we can ask them to draw a map.

  1. Repeated Words

This activity recommended by NeuronUP involves identifying all the words that appear more than once. For example, in this NeuronUP worksheet, we can see that the word “hockey” appears more than once; but is there any other repeated word? How many times does it appear?

References

Aarsland, D., Bronnick, K., Williams-Gray, C., Weintraub, D., Marder, K., Kulisevsky, J., … Emre, M. (2010). Mild cognitive impairment in Parkinson disease: A multicenter pooled analysis. Neurology., 75(12), 1062–9. Disponible en https://www.ncbi.nlm.nih.gov/pubmed/20855849

Reid, W., Hely, M., Morris, J., Loy, C., & Halliday, G. (2011). Dementia in Parkinson’s disease: A 20-year neuropsychological study (Sydney Multicentre study). Journal of neurology, neurosurgery, and psychiatry., 82(9), 1033–7. Disponible enhttps://www.ncbi.nlm.nih.gov/pubmed/21335570

Riedel, O., Rehberg, S. P., Heber, I., Kronenbuerger, M., Schulz, J. B., Storch, A., … Research, P. (2016). Subtypes of mild cognitive impairment in patients with Parkinson’s disease: Evidence from the LANDSCAPE study. Journal of Neurology, Neurosurgery & Psychiatry. doi:10.1136/jnnp-2016-313838

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Authors
Julio Plata-Bello, *María Yaiza Pérez-Martín, Montserrat González-Platas, Víctor Fajardo-Santana, Kritsia Sinay Fumero-Revetti

Department of Neurosurgery, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Spain
*Correspondence to yaizaneuro@hotmail.com

Disclosure
The authors have declared no conflicts of interest.
Citation
EMJ Neurol. 2018;6[1]:46-48. Abstract Review No. AR1
Background

Cognitive impairment is a common disorder in multiple sclerosis (MS), present in >65% of patients both in the early and advanced phases of the disease, and progresses over time.1 This condition can have a significant impact on the quality of life, employment, daily functioning, and independence of patients.

Results regarding cognitive treatment are contradictory, which is probably because the interventions and the outcome measures are heterogeneous. Despite this, different studies have showed that neuropsychological intervention can have favourable effects on the cognitive performance of patients.2-4 Specifically, there is evidence that computer-assisted cognitive rehabilitation improves performance in neuropsychological tests; we therefore designed a study to evaluate the effectiveness of the application of a computer-assisted cognitive rehabilitation therapy in MS patients.

Methods

We included 12 patients in the study. All patients had a diagnosis of relapsing-remitting clinically stable MS; mild-to-moderate cognitive impairment, as established by the Brief Repeatable Battery of Neuropsychological Tests (Rao battery); an adequate level of visual acuity; and were aged >18 years. The patients were evaluated three times: at the beginning of the study, at Week 8, and at Week 16.

Patients were randomised to receive treatment after the first evaluation (Group 1) or after the second evaluation (Group 2). The evaluation consisted of a neuropsychological assessment (using alternative versions of the same battery to reduce the practice-related effects), a functional magnetic resonance study (including a resting functional MRI, a diffusion tensor image, and a Voxel-based morphometry), and a blood sample to identify plasma changes associated with the brain-derived neurotrophic factor protein, which is involved in neuronal plasticity processes. These measures were taken to identify potential biomarkers of therapeutic efficacy.

All patients received 24 sessions of computer-assisted cognitive treatment using the NeuronUP platform. NeuronUP is a cognitive neurorehabilitation online platform that has activities covering 40 neuropsychological processes.5 The rehabilitation sessions were 45 minutes long and were performed three times a week for 8 weeks at the patient’s home.

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Results

Preliminary results showed significant improvements in verbal memory, delayed visual memory, working memory, and semantic fluency.

Structural MRI analysis (Voxel-based morphometry) showed an increase of 0.7% in the global grey matter volume in most patients. Furthermore, resting-state functional MRI studies showed a decrease in fractional amplitude of low-frequency fluctuations in the cingulate cortex, which is involved in learning and memory processes, and in the middle frontal area (Figure 1), suggesting that cognitive therapy improves cognitive performance and may induce structural and functional changes in the brains of MS patients.

Figure 1: Decrease of fractional amplitude of low-frequency fluctuations in the cingulate cortex and middle frontal area after treatment. Conclusion

These findings suggest that cognitive treatment may favour neuroplasticity-inducing changes in the cortical reorganisation, which will help to improve either cognitive or brain reserve.

References
  1. Amato MP et al. Multiple sclerosis-related cognitive changes: A review of cross-sectional and longitudinal studies. J Neurol Sci. 2006;245(1-2):41-5
  2. .De Giglio L et al. A low-cost cognitive rehabilitation with a commercial video game improves sustained attention and executive functions in multiple sclerosis: A pilot study. Neurorehabil Neural Repair. 2015;29(5):453-61.
  3. Shatil E et al. Home-based personalized cognitive training in MS patients: A study of adherence and cognitive performance. Neuro Rehabilitation. 2010;26(2):143-53.
  4. Filippi M et al. Multiple sclerosis: Effects of cognitive rehabilitation on structural and functional MR imaging measures–An explorative study. Radiology. 2012;262(3):932-40.
  5. Muñoz Céspedes JM, Tirapu Ustárroz J. Rehabilitation programs for executive functions. Rev Neurol. 2004;38(7):656-63.

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Brain injury is a leading cause of death and disability among young people and adults worldwide. Due to advances in emergency and critical care services, the number of people who survive a brain injury has increased in recent years. For this reason, professionals in psychology and neuropsychology must improve their knowledge of the clinical, cognitive, emotional and behavioral features that can result from different types of brain injury and how these injuries can affect the individual’s ability to resume work, social activities and familiar relationships.

Daño cerebral (Brain injury) was created with the purpose of becoming a reference book for professionals working in the field of brain injury. The first three chapters cover concepts that are the basis of any condition caused by brain injury: neuroanatomy, neurophysiology and neuroimaging.

Finally, from the fourth chapter onwards, the book reviews the most common types of brain injury, i.e. epilepsy, traumatic brain injury, stroke or cerebrovascular accident, tumors, multiple sclerosis, dementia, infectious diseases of the central nervous system and autoimmune encephalitis.

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Table of contents
  • Acknowledgments
  • Prologue
  • Collaborators
  • Neuroanatomy
  • Neurophysiology
  • Introduction to neuroimaging
  • Epilepsy
  • Traumatic brain injury in adults
  • Stroke
  • Tumors
  • Multiple sclerosis
  • Dementia
  • Infectious diseases of the central nervous system
  • Autoimmune encephalitis
Datos del libro Daño Cerebral

If you would like to purchase either version of the book, click on the following link: https://store.manualmoderno.com/dano-cerebral-9786074487473-9786074487541.html

If you are interested in this book, you might find the following reading recommendations interesting as well:

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By Dr. Pablo Barrecheguren (@pjbarrecheguren)

All artists sign their work, however, by the end of 1999, William Utermohlen could barely remember his signature. Born in Philadelphia (1933), William was a famous American artist living in London until his death in 2007. His oil paintings are characterized by bright colors that are difficult to forget, and yet, one of his last works is made in a sober black and white: a pencil-on-paper self-portrait showing a disfigured face in which it is impossible to recognize Utermohlen himself. This drawing was made in 2000, four years after he was diagnosed with Alzheimer’s disease

Self-portrait. William Utermohlen (2000)

William Utermohlen died in 2007 after eleven years living with Alzheimer’s disease, which places him close to the 4-10 years that a person with Alzheimer’s lives on average, although survival after diagnosis is highly variable and ranges from one year to over twenty. Additionally, it is worth noting that, in retrospect, in many cases, it is possible to detect changes in patients before diagnosis.

Prodromal stage

U.S. President Ronald Reagan, who in 1994 announced he was suffering from Alzheimer’s disease, is a good example of this. Linguistic studies of his 1984 debates indicate that the disease was already beginning to develop: researchers detected Reagan’s speech was 9% slower, and he made up to five times more pauses and frequent minor errors in the use of articles, prepositions, and pronouns. The time interval when early symptoms emerge but they are not serious or apparent enough to make a diagnosis is called the prodromal stage, and can be seen not only in Alzheimer’s but also in other disorders such as schizophrenia.

In the case of Utermohlen, some experts suggest that signs of this prodromal period are apparent in the work of the early 90s, such as in the series titled “Conversation Pieces”, a total of six paintings of his life together with his wife Patricia. A detailed study allows us to observe changes in the spatial representation and disposition of objects and people which, in retrospect, are interpreted as the first signs of a neurodegenerative process.

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Alzheimer’s and motor and sensory abilities

Apart from its long progression, an important characteristic of Alzheimer’s is that it does not affect all areas of the brain at the same time or with the same intensity; most frequently, the process begins in areas involved in the formation of new memories such as the hippocampus and the entorhinal cortex. From these areas neurodegeneration continues through the temporal lobe, which further damages memory as this region plays a critical role in memory storage, and from here continues to the prefrontal cortex. This is relevant because this disease—despite the fact that the stereotype focuses on memory  symptoms—is not only about memory loss: damage to the prefrontal cortex alters basic mechanisms such as attention, emotional regulation, planning, etc., and further weakens the ability to recover memories. Finally, neurodegeneration ends up affecting motor and sensory abilities, although this usually occurs in the late stages.

Artistic skills and Alzheimer’s

This progression by brain areas is an advantage for artists as many of their skills depend on motor and sensory areas. This allows them to continue their profession for a relatively long period of time. There are documented cases of musicians who are still able to play certain melodies even in advanced stages of the disease. The same is true, for example, of painters such as Utermohlen, whose visual cortex took longer to be affected by the disease than parts involved in memory. For this reason, he was still able to paint even when he could no longer remember his own name clearly.

In view of all this, the case of William Utermohlen is not only an extraordinary graphic record of how a person experiences Alzheimer’s; it also reminds us that many artistic skills take time to be affected by Alzheimer’s and, therefore, painting or music may be hobbies that patients will be able to perform to some extent throughout much of the course of their disease.

Self-portrait. William Utermohlen (1996) References
  • Arshavsky, Y. I. (2014). Alzheimer disease and cellular mechanisms of memory storage. Journal of Neuropathology and Experimental Neurology, 73(3), 192–205.
  • Arshavsky, Y. I. (2010). Why Alzheimer’s disease starts with a memory impairment: Neurophysiological insight. Journal of Alzheimer’s Disease, 20(1), 5–16.
  • Bird TD. (2018). Alzheimer Disease Overview. Genes Reviewers
  • Draaisma, D. (2012). Alzheimer, supongo. Editorial Ariel.
  • Casagrande, M., Agostini, F., Boncompagni, I., Cantone, M., Favieri, F., & Guarino, A. (2019). Executive Functions in Alzheimer Disease: A Systematic Review. Frontiers in Aging Neuroscience, 10 (January).
  • Prince, M., Wimo, A., Guerchet, M., Ali, G. C., Wu, Y. T., & Prina, M. (2015). World Alzheimer Report 2015. London, UK. Alzheimer’s Disease International, 1–92.
  • D. (2014). We are our brains. Penguin Random House
  • William Utermohlen: https://www.williamutermohlen.org/index.php/homepage

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