Chronic diseases represent one of the main causes of death worldwide. The integration of digital solutions in clinical interventions is broadly diffused today; however, evidence on their efficacy in addressing psychological comorbidities of chronic diseases is sparse. This systematic review analyzes and synthesizes the evidence about the efficacy of digital interventions on psychological comorbidities outcomes of specific chronic diseases. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of PubMed, PsycInfo, Scopus and Web of Science databases was conducted. Only Randomized Controlled Trials (RCTs) were considered and either depression or anxiety had to be assessed to match the selection criteria. Of the 7636 identified records, 17 matched the inclusion criteria: 9 digital interventions on diabetes, 4 on cardiovascular diseases, 3 on Chronic Obstructive Pulmonary Disease (COPD) and one on stroke. Of the 17 studies reviewed, 14 found digital interventions to be effective. Quantitative synthesis highlighted a moderate and significant overall effect of interventions on depression, while the effect on anxiety was small and non-significant. Design elements making digital interventions effective for psychological comorbidities of chronic diseases were singled out: (a) implementing a communication loop with patients and (b) providing disease-specific digital contents. This focus on “how” to design technologies can facilitate the translation of evidence into practice.

Background: People with chronic neurological diseases, such as Parkinson’s Disease (PD) and Multiple Sclerosis (MS), often present postural disorders and a high risk of falling. When difficulties in achieving outpatient rehabilitation services occur, a solution to guarantee the continuity of care may be telerehabilitation. This study intends to expand the scope of our previously published research on the impact of telerehabilitation on quality of life in an MS sample, testing the impact of this type of intervention in a larger sample of neurological patients also including PD individuals on postural balance. Methods: We included 60 participants with MS and 72 with PD. All enrolled subjects were randomized into two groups: 65 in the intervention group and 67 in the control group. Both treatments lasted 30–40 sessions (5 days/week, 6–8 weeks). Motor, cognitive, and participation outcomes were registered before and after the treatments. Results: All participants improved the outcomes at the end of the treatments. The study’s primary outcome (Mini-BESTest) registered a greater significant improvement in the telerehabilitation group than in the control group. Conclusions: Our results demonstrated that non-immersive virtual reality telerehabilitation is well tolerated and positively affects static and dynamic balance and gait in people with PD and MS.

Verbs are more difficult to produce than nouns. Thus, if executive resources are reduced as in Parkinson's disease (PD), verbs are penalized compared to nouns. However, in an experimental condition in which it is the noun that must be selected from a larger number of alternatives compared to the verb, it is the noun production that becomes slower and more prone to errors. Indeed, patients are slower and less accurate than normal subjects when required to produce nouns from verbs (VN) in a morphology derivation tasks (e.g., “osservazione” from “osservare”) [“observation” from “observe”] than verbs from nouns in a morphology generation task, in which only a verb can be generated from the noun (NV) (e.g., “fallire” from “fallimento”) [“to fail” from “failure”]. In the Italian language morphology, in fact, generation and derivation tasks differ in the number of lexical entries among which the response must be selected. The left Inferior Frontal Gyrus (IFG) has been demonstrated to be involved in selection processes. In the present study, we explored if the ability to select words is related to the cortical thickness of the left IFG. Twelve right-sided PD with nigrostriatal hypofunctionality in the left hemisphere (RPD-LH), 9 left-sided PD with nigrostriatal hypofunctionality in the right hemisphere (LPD-RH) and 19 healthy controls (HC) took part in the study. NV and VN production tasks were administered; accuracy and reaction times (RTs) were collected. All 40 subjects received a structural MRI examination. Cortical thickness of the IFG and volumetric measurements for subcortical regions, thought to support selection processes, were computed using FreeSurfer. In VN derivation tasks RPD-LH patients were less accurate than LPD-RH patients (accuracy: 66% vs. 77%). No difference emerged among the three groups in RTs. Task accuracy/RTs and IFG thickness showed a significant correlation only in RPD-LH. Not only nouns (as expected) but also verbs were correlated with cortical thickness. This suggests that the linguistic nature of the stimuli along with executive resources are both relevant during word selection processes. Our data confirm that executive resources and language interact in the left IFG in word production tasks.

The study of brain venous drainage has gained attention due to its hypothesized link with various neurological conditions. Intracranial and neck venous flow rate may be estimated using cardiac-gated cine phase-contrast (PC)-MRI. Although previous studies showed that breathing influences the neck’s venous flow, this aspect could not be studied using the conventional segmented PC-MRI since it reconstructs a single cardiac cycle. The advent of real-time PC-MRI has overcome these limitations. Using this technique, we measured the internal jugular veins and superior sagittal sinus flow rates in a group of 16 healthy subjects (12 females, median age of 23 years). Comparing forced-breathing and free-breathing, the average flow rate decreased and the respiratory modulation increased. The flow rate decrement may be due to a vasoreactive response to deep breathing. The respiratory modulation increment is due to the thoracic pump’s greater effect during forced breathing compared to free breathing. These results showed that the breathing mode influences the average blood flow and its pulsations. Since effective drainage is fundamental for brain health, rehabilitative studies might use the current setup to investigate if respiratory exercises positively affect clinical variables and venous drainage.

Introduction: Parkinson’s disease (PD) commonly causes speech impairments, including difficulties in expressing emotions through voice. Method: The objective of this study was to investigate gendered vocal expressions of fear, anger, sadness, and happiness for mild to moderate PD. Prosodic features (related to fundamental frequency (F0), intensity (I), speech rate, articulation rate, and number and duration of pauses) and acoustic correlates of voice quality (CPPS, jitter, shimmer, and HNR) were collected from 14 patients with PD (mean age = 69.93; SD = 7.12; 8 males, 6 females) and 13 healthy controls (HC) (mean age = 68.13; SD = 8.27; 5 males, 8 females) matched for age, sex, and years of education. The utterances were extracted from four emotional and one neutral text. The neutral utterance and the emotional utterances were compared. Intra-sex comparison (female with PD vs. female HC and male with PD vs. male HC) and inter-sex comparison (female vs. male both for patients with PD and for HC), were performed with the Mann–Whitney test. A Mann–Whitney test was also used to compare the different emotional conditions, considering sex and PD diagnosis as well. Results: No significant intra-sex differences were found for the neutral speech, but inter-sex differences emerged. Regarding emotional speech, females with PD featured lower MaxF0 than female HCs for happiness and higher intensity variability (SD I) for sadness. Utterances by females with PD had lower CPPS than utterances by HCs for anger and fear. Utterances by males with PD had lower minimum intensity (MinI) than utterances by male HCs when expressing fear. Conclusions: Emotional vocal expression in individuals with PD was found to be impaired and showed sex differences. These findings have the potential to significantly impact the quality of life of PD patients.