Effects of Telerehabilitation on Brain Network Connectivity
Status: Recruiting

The current project aims at assessing the impact of various cognitive telerehabilitation approaches on patients with Mild Cognitive Impairment (MCI) associated with neurodegenerative diseases, namely Alzheimer's disease (AD) and Parkinson's disease (PD). The study focuses on non-pharmacological interventions to maintain patients' residual functionality, limit disease progression, and improve quality of life for both patients and their caregivers.

This longitudinal and multicenter study applies innovative cognitive telerehabilitation (TR) methods and evaluates their impact on functional parameters obtained with high-density electroencephalogram (HD-EEG) and resting-state functional magnetic resonance imaging (rsFMRI). The goal is to identify neurophysiological correlates of the effects of three different cognitive TR in individuals with MCI due to neurodegenerative conditions.

The study aims to:

Identify correlations between improvement in cognitive performance and functional brain data.
Use acquired knowledge to develop neurologically guided TR approaches for broader use.

The research will include patients diagnosed with MCI associated with neurodegenerative diseases. Primary outcome measures include changes in resting-state brain connectivity assessed through HD-EEG and rsFMRI. Secondary outcomes involve the assessment of changes in neuropsychological measures, caregiver burden, immediately after rehabilitation and after longitudinal follow-up.

The study is designed to last 30 months, with follow-up assessments at three time points. The primary outcomes will be evaluated using rsFMRI and HD-EEG instrumental acquisitions, the secondary outcomes will be evaluated using clinical assessments and neuropsychological tests.

Eligibility:
- EligibilityCriteria: Inclusion criteria for MCI-AD subjects:  Confirmed clinical diagnosis of MCI due to possible Alzheimer&#39;s disease with evidence of AD pathophysiological processes, according to National Institute of Neurological and Communicative Disorders and Stroke - Alzheimer's Disease and Related Disorders Association criteria (Albert et al., 2011); Ability to understand and consciously sign informed consent and adhere to study procedures. Educational level ≥ 5 years.  Inclusion criteria for MCI-PD subjects:  Clinical diagnosis of MCI-PD according to Level II criteria (Litvan et al., 2012). Ability to understand and consciously sign informed consent and adhere to study procedures. Educational level ≥ 5 years.  Exclusion criteria:  Aphasia, visuospatial neglect; Atypical and/or secondary parkinsonisms; Dementia according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria; Alterations of consciousness; Sensory disorders that could interfere with the execution of tests and rehabilitative treatment; Concurrent psychiatric and/or neurological and/or essential tremor disorders; Presence of systemic inflammatory and infectious diseases, autoimmune diseases, malignant tumors at the time of recruitment, deemed clinically significant by the investigator and therefore capable of interfering with the study results; Inability or unwillingness to undergo MRI and/or EEG; Presence of prostheses or metallic implants incompatible with MRI; Deep brain stimulation (DBS) implant. Any dropouts will be managed by enrolling new patients. - HealthyVolunteers: No - Gender: All - MinimumAge: 50 Years - MaximumAge: 85 Years - StdAgeList: Adult, Older Adult