Stroke is a major cause of long-term disability and mortality worldwide, often resulting in impairments not only in motor and cognitive functions but also in autonomic nervous system (ANS) regulation. Among the physiological markers that reflect ANS activity, heart rate variability (HRV) has emerged as a promising biomarker for assessing stroke severity and predicting recovery outcomes. HRV quantifies the temporal fluctuations between heartbeats and is traditionally analyzed through time- and frequency-domain measures. More recent approaches have introduced non-linear metrics such as approximate entropy, sample entropy, and detrended fluctuation analysis to capture complex heart rate dynamics. In this narrative review, we address the role of both linear and non-linear HRV parameters in the context of stroke, highlighting their relevance for understanding autonomic dysfunction and guiding rehabilitation. Evidence shows that reduced HRV is associated with poorer functional outcomes, higher mortality, and increased risk of complications post-stroke. Moreover, HRV trends can provide valuable insights into treatment effectiveness and individual recovery trajectories. We also discuss practical considerations for HRV measurement, including device selection, preprocessing strategies, and the need for methodological standardization. Finally, we outline interventional strategies that may enhance HRV and promote better recovery. Together, these findings support the integration of HRV analysis into stroke care as a non-invasive, accessible tool to guide prognosis and tailor interventions.
Pragmatics is key to communicating effectively, and its assessment in vulnerable populations is of paramount importance. Although tools exist for this purpose, they are often effortful and time-consuming, with complex scoring procedures, which hampers their inclusion in clinical practice. To address these issues, we present the Brief Assessment of Pragmatic Abilities and Cognitive Substrates (APACS Brief), a rapid (10 min), easy-to-use and freely distributed tool for evaluating pragmatics in Italian, inspired by the existing APACS test and already validated in the remote version (APACS Brief Remote). The APACS Brief test measures–with a simplified scale–the domains of discourse production and figurative language understanding and is developed in two parallel forms, each including novel items differing from APACS. Psychometric properties, cut-off scores, and thresholds for change were computed on 287 adults. The analysis revealed satisfactory internal consistency, good test–retest reliability, and strong concurrent and construct validity. Moreover, APACS Brief showed excellent discriminant validity on a sample of 56 patients with schizophrenia, who were also cross-classified consistently by APACS Brief and APACS cut-off values. Overall, APACS Brief is a reliable tool for evaluating pragmatic skills and their breakdown, with brief administration time and simple scoring making it well-suited for screening in at-risk populations.
Background. The left and right temporoparietal junctions (TPJs) are two brain areas involved in several brain networks, largely studied for their diverse roles, from attentional orientation to theory of mind and, recently, predictive processing. In predictive processing, one crucial concept is prior precision, that is, the reliability of the predictions of incoming stimuli. This has been linked with modulations of alpha power as measured with electrophysiological techniques, but TPJs have seldom been studied in this framework. Methods. The present article investigates, using magnetoencephalography, whether spontaneous oscillations in pre-stimulus alpha power in the left and right TPJs can modulate brain responses during a linguistic task that requires predictive processing in literal and non-literal sentences. Results. Overall, results show that pre-stimulus alpha power in the rTPJ was associated with post-stimulus responses only in the left superior temporal gyrus, while lTPJ pre-stimulus alpha power was associated with post-stimulus activity in Broca’s area, left middle temporal gyrus, and left superior temporal gyrus. Conclusions. We conclude that both the right and left TPJs have a role in linguistic prediction, involving a network of core language regions, with differences across brain areas and linguistic conditions that can be parsimoniously explained in the context of predictive processing.