Sara Bernini

• Ph.D Psy.D
• Fondazione Istituto Neurologico Nazionale Casimiro Mondino

Background Both anterograde and retrograde amnesia can typically co‐occur in limbic autoimmune encephalitis (LAE), including the forms associated with antibodies to CASPR2/LGI1, two protein complexed with the voltage‐gated potassium channel (VGKC). However, isolated retrograde amnesia is very rare, and it has never been described in LAE. Methods W...

The present study was aimed to cluster sub-groups of patients with varying degrees of cognitive impairment (Subjective Cognitive Decline, mild or Major Neurocognitive Disorder) based on their modifiable risk factors and cognitive reserve with k-means analysis. As a secondary analysis, we described the identified clusters from different perspectives...

The increasing number of dementia cases has determined a growing interest in prevention, with a specific focus on modifiable risk factors (MRFs). In this context, cognitive reserve (CR) may have a role in moderating the association between pathology and neurological symptoms and in buffering the effects of unhealthy MRFs on the clinical manifestati...

Background Currently, the impact of drug therapies on neurodegenerative conditions is limited. Therefore, there is a strong clinical interest in non-pharmacological interventions aimed at preserving functionality, delaying disease progression, reducing disability, and improving quality of life for both patients and their caregivers. This longitudin...

Background Neuropsychiatric symptoms (NPSs) are a distressful aspect of dementia and the knowledge of structural correlates of NPSs is limited. We aimed to identify associations of fronto-limbic circuit with specific NPSs in patients with various types of cognitive impairment. Methods Of 84 participants, 27 were diagnosed with mild cognitive impai...

Polypharmacy (PP) use is very common in older people and may lead to drug-drug interactions (DDIs) and anticholinergic burden (ACB) that may affect cognitive function. We aimed to determine the occurrence of PP, potential DDIs and ACB and their role in cognitive outcomes in an older population. Cross-sectional data from 636 community-dwelling adult...

Background and objectives: Adhering to healthy dietary guidelines plays an essential role in maintaining population health, but data on older people exploring the gender dimension are scarce. We aimed to investigate the gender differences in adherence to dietary recommendations among an Italian population of older men and women. Methods: We include...

Background and objectives: Data on the association of Mediterranean diet and food groups with depressive symptoms in older men and women, are scarce. The aim of this study was to examine the cross-sectional association of adherence to the Mediterranean diet and its food components with depressive symptoms in an Italian cohort of older men and women...

Data on the association of the Mediterranean diet with depressive symptoms in older people at high risk of depression are scarce. This study aimed to investigate the cross-sectional association of the adherence to the Mediterranean diet and its components with depressive symptoms in the Italian NutBrain cohort of older men and women. A total of 325...

Introduction Polypharmacy (PP) use is very common in older people and may lead to anticholinergic burdens that affect cognitive impairment. We aimed to determine the occurrence of PP, drug-drug interactions (DDIs) and anticholinergic burden (ACB) and their role in cognitive outcomes in Italian older population. Methods Cross-sectional data from 636...

Background To date, there is still a lack of consensus for identifying the ideal candidate for cognitive telerehabilitation (TR). The main goal of the present study is to identify the factors associated to the preference for either TR or in-person cognitive training (CT) programs in older adults at risk of dementia or with early cognitive impairmen...

Background: Cognitive dysfunction is a well-established manifestation of the post-COVID syndrome. Psychological vulnerability to stressors can modify disease trajectories, causing long-term risk for negative outcomes. Nonetheless, how premorbid risk factors and response to stressor affect neuropsychological changes is still incompletely understood...

Background Telerehabilitation has enabled a broader application of cognitive rehabilitation programs. We have recently developed HomeCoRe, a system for supporting cognitive intervention remotely with the assistance of a family member. The main goal of the present study was to determine usability and user experience of HomeCoRe in individuals at ris...

The present study aimed to identify clusters of cognitive profiles as well as to explore the effects of these clusters on demographic/individual characteristics and on improvements after a computer-based cognitive training (CCT) in early cognitive impairment. Fifty-seven subjects underwent to an adaptive CCT for 3 weeks (4 individual face-to-face s...

Background COVID-19 has caused a parallel epidemic of fear, anxiety, depression, stress, and frustration, particularly among the most fragile and vulnerable individuals, such as older people and those with previous mental health disorders. The present study aims to investigate the association between pre-existing mental health disorders, particular...

Brain pathologies are characterized by microscopic changes in neurons and synapses that reverberate into large scale networks altering brain dynamics and functional states. An important yet unresolved issue concerns the impact of patients’ excitation/inhibition profiles on neurodegenerative diseases including Alzheimer’s Disease, Frontotemporal Dem...

Background Vascular lesions may be a common finding also in Alzheimer's dementia, but their role on cognitive status is uncertain. Objective to investigate their distribution in patients with Alzheimer's, vascular or mixed dementia and detect any distinctive neuroradiological profiles Methods Seventy-six subjects received a diagnosis of Alzheimer...

Neurological disorders are one of the most common causes of motor/cognitive impairments leading to adult disability. Neurorehabilitation is defined as a complex rehabilitation process directed to recovery from a nervous system injury, and to minimize or compensate the associated functional limitations. The frequent incomplete recovery of the neurol...

It is shown that the circadian system is affected in patients with Alzheimer’s disease (AD) even at an early stage of the disease and that such dysfunction may be detrimental to sleep, mood, and cognitive functioning. Light is a strong central modulator of the circadian rhythms and is potentially beneficial to mood and cognitive functioning via a d...

Background The prevalence of neurodegenerative diseases is expected to increase over the next years, therefore, new methods able to prevent and delay cognitive decline are needed.AimsTo evaluate the effectiveness of a combined treatment protocol associating a computerized cognitive training (CoRe) with anodal transcranial direct current stimulation...

Background: Given the limited effectiveness of pharmacological treatments for cognitive decline, non-pharmacological interventions have gained increasing attention. Evidence exists on the effectiveness of cognitive rehabilitation in preventing elderly subjects at risk of cognitive decline and in reducing the progression of functional disability in...

Brain pathologies are based on microscopic changes in neurons and synapses that reverberate into large scale networks altering brain dynamics and functional states. An important yet unresolved issue concerns the impact of patients excitation/inhibition profiles on neurodegenerative diseases including Alzheimer's disease, Frontotemporal Dementia and...

Background In Parkinson’s disease (PD), physical activity may represent a possible non-pharmacological intervention not only for improving motor symptoms but also for modulating cognitive impairment.AimsTo evaluate the efficacy of an intensive physical program on cognitive functions in mid-stage PD patients with mild cognitive impairment (PD-MCI) o...

Background: The effectiveness of computer-based cognitive training (CCT) remains controversial, especially in older adults with neurodegenerative diseases. Aims: To evaluate the efficacy of CCT in patients with Parkinson's disease and mild cognitive impairment (PD-MCI). Methods: In this randomized controlled trial, 53 patients were randomized...

Background: Smart Aging is a serious game (SG) platform that generates a 3D virtual reality environment in which users perform a set of screening tasks designed to allow evaluation of global cognition. Each task replicates activities of daily living performed in a familiar environment. The main goal of the present study was to ascertain whether Sma...

The COVID-19 poses an ongoing threat to lives around the world and challenges the existing public health and medical service delivery. The lockdown or quarantine measures adopted to prevent the spread of COVID-19 has caused the interruption in ongoing care and access to medical care including to patients with existing neurological conditions. Besid...

The COVID-19 pandemic is a global health problem that is radically transforming public and private healthcare organizations around the world, negatively affecting the rehabilitative treatments of non-COVID pathologies as well. In this situation, it becomes crucial to be able to guarantee the continuity of care also to all those patients with neurod...

Background Frontotemporal Spectrum Disorder (FTSD) and Amyotrophic Lateral Sclerosis (ALS) are neurodegenerative diseases often considered as a continuum from clinical, epidemiologic, and genetic perspectives. We used localized brain volume alterations to evaluate common and specific features of FTSD, FTSD-ALS, and ALS patients to further understan...

Background: Epidemiological evidence suggests that healthy diet is associated with a slowdown of cognitive decline leading to dementia, but the underlying mechanisms are still partially unexplored. Diet is the main determinant of gut microbiota composition, which in turn impacts on brain structures and functions, however to date no studies on this...

The prevalence of dementia is continuously increasing worldwide in aging population. Although neurodegenerative changes account for the majority of dementias, one common etiology shared among all forms is cerebrovascular dysfunction at some point during the disease process. The main aim of this chapter is to summarize the current findings in the fi...

Among dementia-like diseases, Alzheimer disease (AD) and vascular dementia (VD) are two of the most frequent. AD and VD may share multiple neurological symptoms that may lead to controversial diagnoses when using conventional clinical and MRI criteria. Therefore, other approaches are needed to overcome this issue. Machine learning (ML) combined wit...

Objective: Brain atrophy is an established biomarker for dementia, yet spinal cord involvement has not been investigated to date. As the spinal cord is relaying sensorimotor control signals from the cortex to the peripheral nervous system and vice-versa, it is indeed a very interesting question to assess whether it is affected by atrophy due to a d...

Objective: Frontotemporal Lobe Degeneration (FTLD) and Amyotrophic Lateral Sclerosis (ALS) are neurodegenerative diseases more often considered as a continuum from clinical, epidemiologic and genetic perspectives. We used localized brain atrophy to evaluate common and specific features of FTLD, FTLD-ALS and ALS patients to clarify this clinical con...

CoRe is a system for cognitive rehabilitation that has been successfully used for several years in hospital settings. Leveraging on the positive survey results from the potential final users (patients and their home caregivers), we developed HomeCoRe. This new version of the system will allow discharged patients to continue the rehabilitation treat...

Background: There is no successful pharmacological treatment for cognitive impairment in Parkinson's Disease, therefore treatments capable of slowing down the progression of cognitive dysfunction are needed. Objective: To evaluate the effectiveness of a cognitive training, supported by the CoRe computerized tool, in patients with Parkinson's Dis...

Objective: Brain atrophy is an established biomarker for dementia. We hypothesise that spinal cord atrophy is an important in vivo imaging biomarker for neurodegeneration associated with dementia. Methods: 3DT1 images of 31 Alzheimer's disease (AD) and 35 healthy control (HC) subjects were processed to calculate volumes of brain structures and cros...

In the past, little or no attention was paid to cognitive disorders associated with depression (a condition sometimes termed pseudodementia). However, recent years have seen a growing interest in these changes, not only because of their high frequency in acute-stage depression, but also because they have been found to persist, as residual symptoms...

Background: Alzheimer's disease (AD) and dementia are chronic diseases with progressive deterioration of cognition, function, and behavior leading to severe disability and death. The prevalence of AD and dementia is constantly increasing because of the progressive aging of the population. These conditions represent a considerable challenge to patie...

Background beam radiotherapy (IBRT) is increasingly used for the treatment of head/neck cancers in order to spare radiosensitive structures. The occurrence of brain radiation necrosis (RN) following this modality has been reported in small case series, although its long-term outcome has not been clarified yet. The aim of this study is to define the...

One thousand and 679 Alzheimer’s Disease patients (early onset EO: 152 and late onset LO: 1527) were evaluated after 12, 36 and 60 months. At baseline EO patients have higher Mini Mental State examination (MMSE) and fewer comorbidities in respect to LO group. The MMSE score did not significantly differ after 12, 36 and 60 months; a more marked wors...

Alzheimer disease (AD) and vascular dementia (VaD) together represent the majority of dementia cases. Since their neuropsychological profiles often overlap and white matter lesions are observed in elderly subjects including AD, differentiating between VaD and AD can be difficult. Characterization of these different forms of dementia would benefit b...

Background: Smart Aging is a Serious games (SGs) platform in a 3D virtual environment in which users perform a set of screening tests that address various cognitive skills. The tests are structured as 5 tasks of activities of daily life in a familiar environment. The main goal of the present study is to compare a cognitive evaluation made with Smar...

We report an update of our previous observations in Alzheimer's disease (AD) patients in the routine clinical practice considering in particular the interactions between age, concomitant pathologies, and treatment adherence. 2379 AD patients (M/F: 1058/1321, mean age: 74.1 ± 8.8) referred for a first visit to our center from September 2000 to April...

Introduction: The relationship between cognitive and functional impairment in Alzheimer's Disease (AD) at the earliest stages of the disease is not well characterized. This study aimed at investigating such relationships along AD evolution by means of the Disability Assessment for Dementia (DAD). Methods: Consecutive pairs of AD outpatients and...

Background and Purpose Radiation necrosis is a delayed radiation-induced complication, that can causes heterogeneous neurological deficit. However, patients can manifest poor symptoms, in view of a serious radiological situation. Furthermore, the clinical evaluation contemplates the use of brief and analytic-less tools (RTOG/EORTC criteria or CTCAE...

Idiopathic normal pressure hydrocephalus (iNPH) is a complex and still underestimated pathology. In the early stages, the cognitive profile is characterized mainly by impairments of attention, psychomotor speed and memory, suggesting frontal involvement; patients with more advanced iNPH show overall cognitive deterioration. The memory impairment, h...

Purpose: This work aims at providing a tool for supporting cognitive rehabilitation. This is a wide field, that includes a variety of diseases and related clinical pictures; for this reason the need arises to have a tool available that overcomes the difficulties entailed by what currently is the most common approach, that is, the so-called pen and...

Conventional cognitive assessment is based on a pencil-and-paper neuropsychological evaluation, which is time consuming, expensive and requires the involvement of several professionals. Information and communication technology could be exploited to allow the development of tools that are easy to use, reduce the amount of data processing, and provid...

Unlike in other chronic diseases, the Quality of Life (QoL) of patients affected by Alzheimer Disease (AD) has not been well established, primarily because of the difficulties stemming from the study of patients with cognitive disorders. Because no cure is currently available for AD, the optimization of QoL represents the best possible outcome atta...

Parkinson's Disease (PD) is characterized by a wide range of motor and non-motor symptoms. In the last years the evaluation of cognitive functioning, emotional aspects and health status of PD patients has became ever-growing important. In this article a neuropsychological and psychological assessment model, by means of tests and interviews, and a c...