The influence of bilingualism on the assessment and treatment of an Italian–English speaker with the logopenic variant of PPA Roberta Tomasoni, Gaia C. Santi, Serena Tagliente, Chiara Griseta, Simona Aresta, Allegra Benzini, Paola Santacesaria, Cinzia Palmirotta, Maria Luisa Mandelli, Stephanie Grasso, Petronilla Battista Alzheimer S and Dementia Diagnosis Assessment and Disease Monitoring, 2026 INTRODUCTION The impact of bilingualism on speech‐language assessment and therapy in primary progressive aphasia (PPA) remains underexplored, despite its suggested influence on disease presentation. METHODS A bilingual Italian (L1)—English (L2) individual with logopenic‐variant PPA completed a bilingual assessment as well as dual‐language lexical retrieval therapy (LRT). His bilingual experience was characterized in detail, and therapy outcomes were evaluated within and across languages. RESULTS Pre‐morbidly, the patient was a relatively balanced bilingual individual with stronger L1 literacy. Following disease onset, L2 showed faster decline, whereas L1 remained stable. Age at acquisition, dominance, and language use were among the main factors contributing to his language maintenance and decline. Therapy yielded relatively equivalent item‐specific gains in both languages (L1 d 2 = 5.0; L2 d 2 = 5.6), asymmetric crosslinguistic transfer to L2 > L1, and modest functional improvements. DISCUSSION Findings support the relevance of in‐depth bilingual assessment and therapy to guarantee successful treatment in PPA, unveiling the relevance of bilingual experience in shaping treatment outcomes.
“Not That I’ve Become Exceptional, But I’m Able to Make Myself Understood Better”: Impact of Speech and Language Therapy on Everyday Communication in People with Primary Progressive Aphasia and Their Carers Cinzia Palmirotta, Gaia C. Santi, Simona Aresta, Roberta Tomasoni, Allegra Benzini, Giuliana Leccese, Paola Santacesaria, Serena Tagliente, Maura Cosseddu, Federica Biddau, Alessandro Introna, Rosa Capozzo, Stefania Tagliente, Alessandro Padovani, Pietro Fiore, Petronilla Battista Neurology and Therapy, 2026 INTRODUCTION: Primary progressive aphasia (PPA) is a neurodegenerative syndrome characterized by progressive speech and language impairments that impact communication, independence, and psychosocial well-being. People with PPA (PwPPA) and their carers face communication difficulties that lead to social withdrawal. Speech and language therapy (SLT) offers non-pharmacological strategies to support communication, yet evidence regarding its perceived impact on daily life remains limited. This study explored the experiences of PwPPA and their carers following SLT, focusing on perceived changes in communication abilities, confidence, and psychosocial well-being. METHODS: PwPPA participated in a 5-week, tailored telerehabilitation program (Lexical Retrieval Cascade Treatment for logopenic PPA/semantic PPA; Video-Implemented Script Training for nonfluent/agrammatic PPA). Post-treatment questionnaires were developed to collect the opinions of PwPPA and their carers regarding the SLT. The questionnaires included 22 closed-ended Likert-scale items and two open-ended questions for each group. Quantitative data were analyzed for frequency and consistency between PwPPA and carers, while qualitative responses underwent reflexive thematic analysis. Twenty-five PwPPA and 24 carers completed the questionnaires. RESULTS: Quantitative findings showed consistent perceptions between PwPPA and carers, with approximately 30% reporting improvements in communication confidence, speaking ability, and stress. Thematic analysis revealed four shared themes: reduction in negative emotions/increased self-efficacy, proactivity, acquisition of compensatory strategies, and the importance of the treatment setting and patient-clinician relationship. Additional themes included enhanced communicative effectiveness for PwPPA and increased awareness and improved interpersonal relationships for carers. Participants emphasized the benefits of individualized, supportive therapy delivered in a comfortable environment, including via telerehabilitation. CONCLUSION: Our study highlights the positive influence of SLT on both communication and psychosocial outcomes in PwPPA and their carers. Integrating subjective experiences with quantitative measures underscores the importance of person-centered, holistic interventions that address linguistic, emotional, and social dimensions, supporting everyday communication and quality of life.
Neural correlates of prospective memory in Parkinson’s disease: a high-density EEG study Paola Santacesaria, Stefano Vicentin, Giorgia Cona Frontiers in Aging Neuroscience, 2026 Introduction Prospective memory (PM), the ability to remember and execute intended actions in the future, is a critical component of daily functioning and independent living, particularly in individuals with Parkinson’s disease (PD). Although PM deficits in PD have been widely documented, their underlying neural mechanisms remain poorly understood. Methods This study addresses this gap by being the first to investigate the neurophysiological signatures of PM in a sample of 28 PD patients without mild cognitive impairment (MCI) and 34 matched healthy controls using high-density electroencephalography (hd-EEG). Participants completed naturalistic event-based and time-based PM tasks while monitoring virtual cooking activities embedded in a movie presented on a smart TV, with concurrent neurophysiological recording. Results Behavioral performance did not differ between groups in either PM task, likely reflecting preserved global cognition in the PD sample; however, EEG analyses revealed marked oscillatory differences. During time-based PM tasks, PD patients exhibited increased theta, alpha, and beta power, suggesting greater engagement of internal attention monitoring and proactive control mechanisms. Conversely, during event-based PM tasks, PD patients showed reduced power in these frequency bands, consistent with a shift toward externally driven attention to monitor the occurrence of the PM event. Discussion This pattern of findings can be interpreted within the framework of the Attention to Delayed Intention (AtoDI) model. Overall, the present study demonstrates that electrophysiological measures can detect subtle neural alterations in the absence of overt behavioral impairments and can reveal compensatory mechanisms adopted by PD patients to cope with PM demands.
Decoding the neural dynamics of everyday prospective remembering: a hidden Markov model approach Stefano Vicentin, Davide Buzzi Reschini, Paola Santacesaria, Lisa Toffoli, Sara Zago, Giorgio Arcara, Giorgia Cona Frontiers in Human Neuroscience, 2026 Introduction Prospective memory (PM)—the ability to form, maintain, and execute delayed intentions—is essential for everyday functioning. Traditionally, PM paradigms relied on repetitive tasks and focused on transient post-stimulus activity, overlooking the sustained neural processes supporting intention maintenance. Methods High-density EEG data were recorded during a naturalistic PM paradigm simulating everyday activities (preparing a meal while watching TV), comprising three conditions: naturalistic viewing, event-based PM, and time-based PM. Using individual MRI and hidden Markov modeling (HMM), brain activity was studied at the source level and splitted into an optimal number of states. Results The HMM analysis identified 6 brain states. Among them, State 3 was characterized by activations over regions of the dorsal attention network (DAN) and was more prominent during the timebased PM task, consistently with the DAN role in sustained attention and time monitoring. State 6, involving core regions of the default mode network (DMN), showed longer inter-activation intervals, suggesting a role in transient and sporadic processes (intention retrieval). Crucially, efficient time checks positively correlated with time spent in these two brain states, linking them to PM accuracy. Discussion These findings suggest complementary roles of DAN and DMN regions in prospective remembering—continuous monitoring versus retrieval—and demonstrate how combining HMM with naturalistic paradigms offers new insights into the neural dynamics underlying real-world intention maintenance.
Digital phenotyping of Parkinson’s disease via natural language processing Simona Aresta, Petronilla Battista, Cinzia Palmirotta, Serena Tagliente, Gianvito Lagravinese, Paola Santacesaria, Allegra Benzini, Davide Mongelli, Brigida Minafra, Christian Lunetta, Adolfo M. García, Christian Salvatore Npj Parkinson S Disease, 2025 Frontostriatal degeneration in Parkinson's disease (PD) is associated with language deficits, which can be identified using natural language processing, a remarkable tool for digital-phenotyping. Current evidence is mostly blind to the disorder's cognitive phenotypes. We validated an AI-driven approach to capture digital language markers of PD with and without mild cognitive impairment (PD-MCI, PD-nMCI) relative to healthy controls (HCs). Analyzing the connected speech of participants, we extracted linguistic features with CLAN software. Classification was performed using SVM and RFE. Discrimination between PD and HCs reached an AUC of 77%, with even better results for subgroup analyses (AUC: 85% PD-nMCI vs. HCs; 83% PD-MCI vs. HCs; 75% PD-nMCI vs. PD-MCI). Key linguistic features included retracing, action verb, utterance error, and verbless-utterance ratios. Despite the small sample size, which may limit statistical power and generalizability, this study highlights the foundational potential of linguistic digital markers for early diagnosis and phenotyping of PD.
Transcranial alternating current stimulation selectively modulates aperiodic EEG component: Unveiling alternative mechanisms of modulation Fabio Masina, Ettore Napoli, Paola Santacesaria, Andreina Giustiniani, Sara Zago, Marco Marino, Rachele Pezzetta, Sonia Montemurro, Nicoletta Manzo, Giorgia Cona, Daniela Mapelli, Giorgio Arcara Clinical Neurophysiology, 2025 OBJECTIVE: Transcranial alternating current stimulation (tACS) mechanisms remain poorly understood. While tACS is expected to modulate periodic electroencephalography (EEG) activity due to the imposition of oscillatory alternating currents, it may also modulate the aperiodic EEG component, suggesting alternative tACS mechanisms that have not yet been explored. This study examined whether 20-minute tACS session delivered at 40 Hz over C3/C4 can selectively modulate periodic and aperiodic components. METHODS: We implemented a paired, counterbalanced, and sham-controlled design consisting of two sessions during which tACS was administered over the sensorimotor regions. EEG was recorded before and after tACS under three EEG conditions: resting state, active task (i.e., the serial reaction time task), and passive task (i.e., 40-Hz auditory stimulation). RESULTS: We found that tACS led to selective modulation of the aperiodic component, specifically a broadband downward shift in the power spectrum (i.e., reduction in the offset), independent of the EEG conditions and with no evidence of an effect on periodic activity. CONCLUSION: This result may reflect a general effect on neural spiking rather than direct modulation of oscillatory activity. SIGNIFICANCE: Disentangling the contribution of the aperiodic component from periodic activity represents an opportunity to identify alternative neurophysiological mechanisms underlying neural modulation and provides a clearer interpretation of tACS mechanisms.
Unveiling the neural correlates of prospective memory: An ecological EEG study Paola Santacesaria, Stefano Vicentin, Sara Zago, Giorgio Arcara, Giorgia Cona Biological Psychology, 2025 The ability to remember intentions for future actions is a fundamental aspect of human functioning in everyday life. This process is typically studied in laboratory settings with tasks designed to isolate it, but these often lack ecological validity because they may not fully capture the complexity and variability of prospective memory (PM) in real-world contexts. The present exploratory study was designed to overcome these limitations. Firstly, participants watched a movie simulating to be home on their sofa. They then continued to watch the movie on their "smart TV", while simultaneously maintaining and executing intentions related to everyday activities, such as "virtual cooking". Neurophysiological activity was recorded during these tasks using an hd-EEG system to investigate the role of brain oscillations in strategic monitoring processes involved in PM. Power spectral density was analyzed across the theta, alpha, and high beta frequency bands. Administration of time-based and event-based instructions in an ecological context revealed two distinct patterns of brain activity. Time-based PM was characterized by widespread and sustained fronto-temporal activation, along with pronounced engagement of high beta frequencies in prefrontal areas. Event-based PM was associated with theta and alpha power localized to focal areas of the occipito-parietal lobes. According to the PM literature, modulations of theta and alpha oscillations are associated with attentional mechanisms for rehearsing different PM intentions in memory. The involvement of high beta frequencies in the time-based PM condition, already associated with temporal abilities, highlights their role in determining optimal timing for retrieval of future intentions.
Effectiveness of a home-based computerized cognitive training in Parkinson's disease: a pilot randomized cross-over study Serena Tagliente, Brigida Minafra, Simona Aresta, Paola Santacesaria, Andrea Buccoliero, Cinzia Palmirotta, Gianvito Lagravinese, Davide Mongelli, Christian Gelao, Luigi Macchitella, Stefania Pazzi, Domenico Scrutinio, Paola Baiardi, Petronilla Battista Frontiers in Psychology, 2024 IntroductionCognitive symptoms are common in Parkinson's Disease (PD), and digital interventions like telerehabilitation other an accessible way to manage these symptoms. This study aimed to assess the effectiveness of a Home-Based Computerized Cognitive Training (HB-CCT) program in individuals with PD using a pilot randomized cross-over design.MethodsTwenty-five participants (mean age 69.32 ± 7.21 years, mean MDS-UPDRS III 33.76 ± 14.25) with PD and mild cognitive impairment were enrolled. They underwent neuropsychological assessments at three time points (5-week intervals): Baseline, after the HB-CCTi, and after Standard Care. The HB-CCT consisted of the Neurotablet® platform that was used to target cognitive domains such as Attention, Memory, Perception, Executive Functioning and Language. All participants completed both the Neurotablet intervention and Standard Care blocks in a randomized order. After a Shapiro-Wilk test, non-parametric repeated measures analyses of variance (Friedman's test) and post-hoc comparisons corrected with the Benjamini-Hochberg approach were performed to compare the effects on primary and secondary cognitive outcomes over experimental intervention and Standard Care.ResultsThe results from the Friedman analysis revealed significant improvements in Word List Immediate Recall, Digit Span Forward and Complex Figure Recall (all p < 0.001) following the HB-CCT, compared to the Baseline. Additionally, Naming performance showed significant improvement after the HB-CCT (p = 0.02). Significant differences were also observed when comparing the HB-CCT with Standard Care, with improved performance in TMT-A (p = 0.02), Phonemic Fluency (p < 0.01), and Digit Span Forward (p < 0.01).DiscussionThese findings suggest that HB-CCT via Neurotablet can effectively enhance specific cognitive abilities in PD, supporting the role of digital, home-based interventions as feasible strategies to mitigate cognitive decline.
Envisioning the future: An ALE meta-analysis on neural correlates of future thinking, prospective memory and delay discounting Giorgia Cona, Paola Santacesaria, Cristina Scarpazza Neuroscience and Biobehavioral Reviews, 2023 Our representations of the future are processed in the service of several different cognitive functions, including episodic future thinking, prospective memory, and temporal discounting. The present meta-analysis used the Activation Likelihood Estimation method to understand whether there is a core network underlying future-oriented cognition and to identify the specific brain regions that support future-related processes in each function. Following the PRISMA guidelines, a total of 24, 19, and 27 neuroimaging studies were included for future thinking, prospective memory, and temporal discounting, respectively. Results showed that there is no specific region or network for the future. Instead, the 'future' seems to be represented on an anterior-posterior tangibility gradient, based on the level of abstractness/concreteness of the simulated scenario. Additionally, future-oriented cognition is mediated by two distinct networks: the Default Network and the Salience Network. The Default Network is mainly active in supporting future thinking, whereas the Salience Network is primarily involved in prospective memory and delay discounting.
The influence of bilingualism on the assessment and treatment of an Italian–English speaker with the logopenic variant of PPA R Tomasoni, GC Santi, S Tagliente, C Griseta, S Aresta, A Benzini, ... Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring 18 (2 … , 2026 2026.0
Neural correlates of prospective memory in Parkinson’s disease: a high-density EEG study P Santacesaria, S Vicentin, G Cona Frontiers in Aging Neuroscience 18, 1683562 , 2026 2026.0 Citations: 1
“Not That I’ve Become Exceptional, But I’m Able to Make Myself Understood Better”: Impact of Speech and Language Therapy on Everyday Communication in People with Primary … C Palmirotta, GC Santi, S Aresta, R Tomasoni, A Benzini, G Leccese, ... Neurology and Therapy, 1-15 , 2026 2026.0
Natural Language Processing differentiates between Italian individuals with Nonfluent/Agrammatic from Logopenic variants of PPA P Battista, S Aresta, P Santacesaria, A Benzini, C Palmirotta, S Tagliente, ... Alzheimer's & Dementia 21, e105208 , 2025 2025.0
Unveiling the neural correlates of prospective memory: An ecological EEG study P Santacesaria, S Vicentin, S Zago, G Arcara, G Cona Biological Psychology, 109083 , 2025 2025.0 Citations: 3
Transcranial alternating current stimulation selectively modulates aperiodic EEG component: Unveiling alternative mechanisms of modulation F Masina, E Napoli, P Santacesaria, A Giustiniani, S Zago, M Marino, ... Clinical Neurophysiology, 2110929 , 2025 2025.0 Citations: 8
Digital phenotyping of Parkinson’s disease via natural language processing S Aresta, P Battista, C Palmirotta, S Tagliente, G Lagravinese, ... npj Parkinson's Disease 11 (1), 182 , 2025 2025.0 Citations: 11
Natural language processing distinguishes Italian individuals with nonfluent/agrammatic from logopenic variants of PPA P Battista, S Aresta, P Santacesaria, A Benzini, C Palmirotta, S Tagliente, ... EUROPEAN JOURNAL OF NEUROLOGY 32 , 2025 2025.0
Future-oriented cognition: identifying cognitive and neural mechanisms in healthy and pathological populations P Santacesaria Università degli studi di Padova , 2025 2025.0
Effectiveness of a home-based computerized cognitive training in Parkinson's disease: a pilot randomized cross-over study S Tagliente, B Minafra, S Aresta, P Santacesaria, A Buccoliero, ... Frontiers in Psychology 15, 1531688 , 2025 2025.0 Citations: 9
Decoding the neural dynamics of everyday prospective remembering: a hidden Markov model approach S Vicentin, DB Reschini, P Santacesaria, L Toffoli, S Zago, G Arcara, ... Frontiers in Human Neuroscience 19, 1686657 , 2025 2025.0
Selective tACS modulation of aperiodic EEG components: unveiling alternative mechanisms of neural modulation F Masina, E Napoli, P Santacesaria, A Giustiniani, G Cona, D Mapelli, ... Brain Stimulation: Basic, Translational, and Clinical Research in … , 2025 2025.0
Envisioning the future: An ALE meta-analysis on neural correlates of future thinking, prospective memory and delay discounting G Cona, P Santacesaria, C Scarpazza Neuroscience & Biobehavioral Reviews 153, 105355 , 2023 2023.0 Citations: 33
Vision recovery with perceptual learning and non-invasive brain stimulation: Experimental set-ups and recent results, a review of the literature L Battaglini, M Di Ponzio, A Ghiani, F Mena, P Santacesaria, C Casco Restorative Neurology and Neuroscience 40 (3), 137-168 , 2022 2022.0 Citations: 24
Roberta Tomasoni 1 Gaia C. Santi 1 Serena Tagliente 1 Chiara Griseta S Aresta, A Benzini, P Santacesaria, C Palmirotta, ML Mandelli, S Grasso, ...
Automated Multimodal Acoustic and Linguistic Analysis for Detection and Cognitive Characterization in Parkinson’s Disease S Aresta, F Pierotti, A Benzini, GC Santi, C Palmirotta, S Tagliente, ...
MOST CITED SCHOLAR PUBLICATIONS
Envisioning the future: An ALE meta-analysis on neural correlates of future thinking, prospective memory and delay discounting G Cona, P Santacesaria, C Scarpazza Neuroscience & Biobehavioral Reviews 153, 105355 , 2023 2023.0 Citations: 33
Vision recovery with perceptual learning and non-invasive brain stimulation: Experimental set-ups and recent results, a review of the literature L Battaglini, M Di Ponzio, A Ghiani, F Mena, P Santacesaria, C Casco Restorative Neurology and Neuroscience 40 (3), 137-168 , 2022 2022.0 Citations: 24
Digital phenotyping of Parkinson’s disease via natural language processing S Aresta, P Battista, C Palmirotta, S Tagliente, G Lagravinese, ... npj Parkinson's Disease 11 (1), 182 , 2025 2025.0 Citations: 11
Effectiveness of a home-based computerized cognitive training in Parkinson's disease: a pilot randomized cross-over study S Tagliente, B Minafra, S Aresta, P Santacesaria, A Buccoliero, ... Frontiers in Psychology 15, 1531688 , 2025 2025.0 Citations: 9
Transcranial alternating current stimulation selectively modulates aperiodic EEG component: Unveiling alternative mechanisms of modulation F Masina, E Napoli, P Santacesaria, A Giustiniani, S Zago, M Marino, ... Clinical Neurophysiology, 2110929 , 2025 2025.0 Citations: 8
Unveiling the neural correlates of prospective memory: An ecological EEG study P Santacesaria, S Vicentin, S Zago, G Arcara, G Cona Biological Psychology, 109083 , 2025 2025.0 Citations: 3
Neural correlates of prospective memory in Parkinson’s disease: a high-density EEG study P Santacesaria, S Vicentin, G Cona Frontiers in Aging Neuroscience 18, 1683562 , 2026 2026.0 Citations: 1
The influence of bilingualism on the assessment and treatment of an Italian–English speaker with the logopenic variant of PPA R Tomasoni, GC Santi, S Tagliente, C Griseta, S Aresta, A Benzini, ... Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring 18 (2 … , 2026 2026.0
“Not That I’ve Become Exceptional, But I’m Able to Make Myself Understood Better”: Impact of Speech and Language Therapy on Everyday Communication in People with Primary … C Palmirotta, GC Santi, S Aresta, R Tomasoni, A Benzini, G Leccese, ... Neurology and Therapy, 1-15 , 2026 2026.0
Natural Language Processing differentiates between Italian individuals with Nonfluent/Agrammatic from Logopenic variants of PPA P Battista, S Aresta, P Santacesaria, A Benzini, C Palmirotta, S Tagliente, ... Alzheimer's & Dementia 21, e105208 , 2025 2025.0
Natural language processing distinguishes Italian individuals with nonfluent/agrammatic from logopenic variants of PPA P Battista, S Aresta, P Santacesaria, A Benzini, C Palmirotta, S Tagliente, ... EUROPEAN JOURNAL OF NEUROLOGY 32 , 2025 2025.0
Future-oriented cognition: identifying cognitive and neural mechanisms in healthy and pathological populations P Santacesaria Università degli studi di Padova , 2025 2025.0
Decoding the neural dynamics of everyday prospective remembering: a hidden Markov model approach S Vicentin, DB Reschini, P Santacesaria, L Toffoli, S Zago, G Arcara, ... Frontiers in Human Neuroscience 19, 1686657 , 2025 2025.0
Selective tACS modulation of aperiodic EEG components: unveiling alternative mechanisms of neural modulation F Masina, E Napoli, P Santacesaria, A Giustiniani, G Cona, D Mapelli, ... Brain Stimulation: Basic, Translational, and Clinical Research in … , 2025 2025.0
Roberta Tomasoni 1 Gaia C. Santi 1 Serena Tagliente 1 Chiara Griseta S Aresta, A Benzini, P Santacesaria, C Palmirotta, ML Mandelli, S Grasso, ...
Automated Multimodal Acoustic and Linguistic Analysis for Detection and Cognitive Characterization in Parkinson’s Disease S Aresta, F Pierotti, A Benzini, GC Santi, C Palmirotta, S Tagliente, ...
