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Westerhausen R. Interhemispheric Integration after Callosotomy: A Meta-Analysis of Poffenberger and Redundant-Target Paradigms. Neuropsychol Rev 2023; 33:872-890. [PMID: 36484870 PMCID: PMC10769931 DOI: 10.1007/s11065-022-09569-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/16/2022] [Indexed: 12/13/2022]
Abstract
The central role of the corpus callosum in integrating perception and cognition across the cerebral hemispheres makes it highly desirable for clinical and basic research to have a repertoire of experimental paradigms assessing callosal functioning. Here, the objective was to assess the validity of two such paradigms (Poffenberger, redundant-target paradigms) by conducting single-step meta-analyses on individual case data of callosotomy patients. Studies were identified by systematic literature search (source: Pubmed and WebOfKnowledge, date: 07.03.2022) and all studies were included that reported callosotomy case data for either paradigm. Twenty-two studies (38 unique cases) provided 116 observations of the crossed-uncrossed difference (CUD) for the Poffenberger paradigm, while ten studies (22 cases, 103 observations) provided bilateral redundancy gain (bRG) measures. Using linear-mixed models with "individual" and "experiment" as random-effects variable, the mean CUD was estimated at 60.6 ms (CI95%: 45.3; 75.9) for commissurotomy, 43.5 ms (26.7; 60.2) for complete callosotomy, and 8.8 ms (1.1; 16.6) for partial anterior-medial callosotomy patients. The estimates of commissurotomy/callosotomy patients differed significantly from patients with partial callosotomy and healthy controls. The mean bRGmin (minimum unilateral reference) was estimated at 42.8 ms (27.1;58.4) for patients with complete and 30.8 ms (16.8; 44.7) for patients with partial callosotomy, both differing significantly from controls. One limitation was that different formulas for bRG were used, making it necessary to split the sample and reducing test power of some analyses. Nevertheless, the present findings suggest that both paradigms assess interhemispheric callosal integration, confirming their construct validity, but likely test distinct callosal functions.
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Affiliation(s)
- René Westerhausen
- Section for Cognitive and Clinical Neuroscience, Department of Psychology, University of Oslo, POB 1094 Blindern, Oslo, 0317, Norway.
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2
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Lunven M, Toba MN, Bartolomeo P. Prism adaptation therapy in spatial neglect: The importance of connectional anatomy. Neuropsychologia 2023; 188:108640. [PMID: 37423424 DOI: 10.1016/j.neuropsychologia.2023.108640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
The meta-analysis conducted by Székely et al. described the lack of beneficial effect of prism adaptation in neglect patients. The authors concluded that the results did "not support the routine use of prism adaptation as a therapy for spatial neglect". However, a possible nuance to this conclusion could be that the response (or lack thereof) of neglect patients to prism adaptation may actually depend on the connectional anatomy of their lesion. We develop this idea in our commentary, in order to offer a more balanced perspective on the implications of the findings obtained by Székely et al.
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Affiliation(s)
- Marine Lunven
- Département D'Etudes Cognitives, École Normale Supérieure, PSL University, 75005, Paris, France; University Paris Est Creteil, INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, F-94010, Creteil, France
| | - Monica N Toba
- Laboratory of Functional Neurosciences (UR UPJV 4559), University of Picardy Jules Verne and University Hospital of Amiens, Amiens, France; Sorbonne Université, Inserm U 1127, CNRS UMR 7225, Paris Brain Institute, ICM, Hôpital de La Pitié-Salpêtrière, 75013, Paris, France
| | - Paolo Bartolomeo
- Sorbonne Université, Inserm U 1127, CNRS UMR 7225, Paris Brain Institute, ICM, Hôpital de La Pitié-Salpêtrière, 75013, Paris, France.
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3
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Wiesen D, Bonilha L, Rorden C, Karnath HO. Disconnectomics to unravel the network underlying deficits of spatial exploration and attention. Sci Rep 2022; 12:22315. [PMID: 36566307 PMCID: PMC9789971 DOI: 10.1038/s41598-022-26491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/15/2022] [Indexed: 12/25/2022] Open
Abstract
Spatial attention and exploration are related to a predominantly right hemispheric network structure. However, the areas of the brain involved and their exact role is still debated. Spatial neglect following right hemispheric stroke lesions has been frequently viewed as a model to study these processes in humans. Previous investigations on the anatomical basis on spatial neglect predominantly focused on focal brain damage and lesion-behaviour mapping analyses. This approach might not be suited to detect remote areas structurally spared but which might contribute to the behavioural deficit. In the present study of a sample of 203 right hemispheric stroke patients, we combined connectome lesion-symptom mapping with multivariate support vector regression to unravel the complex and disconnected network structure in spatial neglect. We delineated three central nodes that were extensively disconnected from other intrahemispheric areas, namely the right superior parietal lobule, the insula, and the temporal pole. Additionally, the analysis allocated central roles within this network to the inferior frontal gyrus (pars triangularis and opercularis), right middle temporal gyrus, right temporal pole and left and right orbitofrontal cortices, including interhemispheric disconnection. Our results suggest that these structures-although not necessarily directly damaged-might play a role within the network underlying spatial neglect in humans.
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Affiliation(s)
- Daniel Wiesen
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany.
| | | | | | - Hans-Otto Karnath
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany
- Department of Psychology, University of South Carolina, Columbia, USA
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4
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Li L, Huang H. Noninvasive neuromodulation for unilateral neglect after stroke: a systematic review and network meta-analysis. Neurol Sci 2022; 43:5861-5874. [PMID: 35660991 DOI: 10.1007/s10072-022-06187-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To systematically evaluate the effect of noninvasive neuromodulation (NINM) on unilateral neglect (UN) after stroke and compare the effects of different NINMs. METHODS Randomized controlled trials (RCTs) on the effect of NINM on UN after stroke were retrieved from the PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP, and CBM databases from inception to January 2022. The risk of bias and quality of the trials were assessed following the Cochrane Handbook of Systematic Reviews and the physiotherapy evidence database PEDro Scale. Statistical analysis was conducted with Stata 16.0 and R 4.0.2. This study was registered on PROSPERO (No. CRD42021295336). RESULTS A total of 12 RCTs involving 291 patients were included. Meta-analysis showed that NINM could reduce the line bisection test (LBT) score (SMD = - 1.56, 95% CI - 2.10 ~ - 1.03, P < 0.05), the line cancellation test score (SMD = - 1.83, 95% CI - 2.39 ~ - 1.27, P < 0.05), and the star cancellation test score (SMD = - 2.85, 95% CI - 4.93 ~ - 0.76, P < 0.05). Network meta-analysis showed that the best probabilistic ranking of the effects of different NINMs on the LBT score was theta-burst stimulation (TBS) (P = 0.915) > repetitive transcranial magnetic stimulation (P = 0.068) > transcranial direct current stimulation (P = 0.018). CONCLUSION Existing evidence showed that NINM could improve UN after stroke and that TBS was best. Due to the number of included studies and sample size, more large-sample, multicenter, double-blinded, high-quality clinical RCTs are still needed in the future to further confirm the results of this research.
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Affiliation(s)
- Lingling Li
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250355, Shandong, China
| | - Hailiang Huang
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250355, Shandong, China.
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5
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Tomaiuolo F, Raffa G, Campana S, Garufi G, Lasaponara S, Voci L, Cardali SM, Germanò A, Doricchi F, Petrides M. Splenial Callosal Disconnection in Right Hemianopic Patients Induces Right Visual-Spatial Neglect. Brain Sci 2022; 12:brainsci12050640. [PMID: 35625026 PMCID: PMC9139425 DOI: 10.3390/brainsci12050640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/22/2022] [Accepted: 05/04/2022] [Indexed: 02/04/2023] Open
Abstract
Posterior cerebral artery (PCA) territory infarction involving occipital cortical damage can give rise to contralateral homonymous hemianopia. Here, we report two rare cases of patients with lesions in the left hemisphere PCA territory who developed right visuo-spatial neglect. One patient suffered right hemianopia and right visuo-spatial neglect after a stroke that damaged the left primary visual cortex and the callosal splenial fibers. The other unique case is of a patient who had a brain tumor in the posterior cerebral region in the left hemisphere and initially exhibited only right hemianopia that developed into right visuo-spatial neglect after tumor resection that included the splenial fibers. These cases indicate that, as in cases with damage in the right PCA territory, lesions in the left PCA yield visuo-spatial neglect when the damage produces contralateral hemianopia and concomitant disconnection of the splenium of the corpus callosum, which interferes with the arrival of visual inputs from the intact right to the lesioned left hemisphere. These results also emphasize the necessity of sparing the splenial fibers in surgical interventions in patients who exhibit hemianopia.
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Affiliation(s)
- Francesco Tomaiuolo
- Department of Clinical and Experimental Medicine, University of Messina, Piazza Pugliatti, 1, 98122 Messina, Italy
- Correspondence: (F.T.); (A.G.)
| | - Giovanni Raffa
- Division of Neurosurgery, Department BIOMORF, University of Messina, Piazza Pugliatti, 1, 98122 Messina, Italy; (G.R.); (G.G.); (S.M.C.)
| | - Serena Campana
- Neurorehabilitation Unit, Auxilium Vitae Volterra, Via Borgo San Lazzero 5, 56048 Volterra, Italy; (S.C.); (L.V.)
| | - Giada Garufi
- Division of Neurosurgery, Department BIOMORF, University of Messina, Piazza Pugliatti, 1, 98122 Messina, Italy; (G.R.); (G.G.); (S.M.C.)
| | - Stefano Lasaponara
- Department of Psychology, La Sapienza University, Piazzale Aldo Moro 5, 00185 Rome, Italy; (S.L.); (F.D.)
- Laboratorio di Neuropsicologia dell’Attenzione, Fondazione Santa Lucia IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
- Dipartimento di Scienze Umane, Libera Università Maria Santissima Assunta LUMSA, Via della Traspontina, 21, 00193 Rome, Italy
| | - Loredana Voci
- Neurorehabilitation Unit, Auxilium Vitae Volterra, Via Borgo San Lazzero 5, 56048 Volterra, Italy; (S.C.); (L.V.)
| | - Salvatore M. Cardali
- Division of Neurosurgery, Department BIOMORF, University of Messina, Piazza Pugliatti, 1, 98122 Messina, Italy; (G.R.); (G.G.); (S.M.C.)
| | - Antonino Germanò
- Division of Neurosurgery, Department BIOMORF, University of Messina, Piazza Pugliatti, 1, 98122 Messina, Italy; (G.R.); (G.G.); (S.M.C.)
- Correspondence: (F.T.); (A.G.)
| | - Fabrizio Doricchi
- Department of Psychology, La Sapienza University, Piazzale Aldo Moro 5, 00185 Rome, Italy; (S.L.); (F.D.)
- Laboratorio di Neuropsicologia dell’Attenzione, Fondazione Santa Lucia IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Michael Petrides
- Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, QC H3A 2B4, Canada;
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6
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Abstract
In the human brain, the temporal-parietal junction (TPJ) is a histologically heterogenous area that includes the ventral portions of the parietal cortex and the caudal superior temporal gyrus sector adjacent to the posterior end of the Sylvian fissure. The anatomical heterogeneity of the TPJ is matched by its seemingly ubiquitous involvement in different cognitive functions that span from memory to language, attention, self-consciousness, and social behavior. In line with established clinical evidence, recent fMRI investigations have confirmed relevant hemispheric differences in the TPJ function. Most importantly, the same investigations have highlighted that, in each hemisphere, different subsectors of the TPJ are putatively involved in different cognitive functions. Here I review empirical evidence and theoretical proposals that were recently advanced to gain a unifying interpretation of TPJ function(s). In the final part of the review, a new overarching interpretation of the TPJ function is proposed. Current advances in cognitive neuroscience can provide important insights that help improve the clinical understanding of cognitive deficits experienced by patients with lesions centered in or involving the TPJ area.
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Affiliation(s)
- Fabrizio Doricchi
- Department of Psychology, "La Sapienza" University, Rome, Italy; Laboratory of Neuropsychology of Attention, I.R.C.C.S. Santa Lucia Foundation, Rome, Italy.
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7
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Bartolomeo P. From competition to cooperation: Visual neglect across the hemispheres. Rev Neurol (Paris) 2021; 177:1104-1111. [PMID: 34561121 DOI: 10.1016/j.neurol.2021.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 07/23/2021] [Indexed: 12/13/2022]
Abstract
Visuospatial neglect is a frequent and disabling consequence of injuries to the right hemisphere. Patients with neglect show signs of impaired attention for left-sided events, which depends on dysfunction of fronto-parietal networks. After unilateral injury, such as stroke, these networks and their contralateral homologs can reorganize following multiple potential trajectories, which can be either adaptive or maladaptive. This article presents possible factors influencing the profile of evolution of neglect towards recovery or chronicity, and highlights potential mechanisms that may constrain these processes in time and space. The integrity of white matter pathways within and between the hemisphere appears to pose crucial connectivity constraints for compensatory brain plasticity from remote brain regions. Specifically, the availability of a sufficient degree of inter-hemispheric connectivity might be critical to shift the role of the undamaged left hemisphere in spatial neglect, from exerting maladaptive effects, to promoting compensatory activity.
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Affiliation(s)
- P Bartolomeo
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, hôpital de la Pitié-Salpêtrière, 75013 Paris, France.
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8
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Doricchi F, Pinto M, Pellegrino M, Marson F, Aiello M, Campana S, Tomaiuolo F, Lasaponara S. Deficits of hierarchical predictive coding in left spatial neglect. Brain Commun 2021; 3:fcab111. [PMID: 34151266 PMCID: PMC8209285 DOI: 10.1093/braincomms/fcab111] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 04/10/2021] [Accepted: 05/27/2021] [Indexed: 12/21/2022] Open
Abstract
Right brain-damaged patients with unilateral spatial neglect fail to explore the left side of space. Recent EEG and clinical evidence suggests that neglect patients might suffer deficits in predictive coding, i.e. in identifying and exploiting probabilistic associations among sensory stimuli in the environment. To gain direct insights on this issue, we focussed on the hierarchical components of predictive coding. We recorded EEG responses evoked by central, left-side or right-side tones that were presented at the end of sequences of four central tones. Left-side and right-side deviant tones produce a pre-attentive Mismatch Negativity that reflects a lower-order prediction error for the 'Local' deviation of the tone at the end of the sequence. Higher-order prediction errors for the frequency of these deviations in the acoustic environment, i.e. 'Global' deviation, are marked by the P3 response. We show that when neglect patients are immersed in an acoustic environment characterized by frequent left-side deviant tones, they display no pre-attentive Mismatch Negativity both for left-side deviant tones and infrequent omissions of the last tone, while they have Mismatch Negativity for infrequent right-side deviant tones. In the same condition, neglect patients show no P300 response to 'Global' prediction errors for deviant tones, including those in the non-neglected right-side, and omissions. In contrast to this, when right-side deviant tones are predominant in the acoustic environment, neglect patients have pre-attentive Mismatch Negativity both for right-side deviant tones and infrequent omissions, while they display no Mismatch Negativity for infrequent left-side deviant tones. Most importantly, in the same condition neglect patients show enhanced P300 response to infrequent left-side deviant tones, notwithstanding that these tones evoked no pre-attentive Mismatch Negativity. This latter finding indicates that 'Global' predictions are independent of 'Local' error signals provided by the Mismatch Negativity. These results qualify deficits of predictive coding in the spatial neglect syndrome and show that neglect patients base their predictive behaviour only on statistical regularities that are related to the frequent occurrence of sensory events on the right side of space.
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Affiliation(s)
- Fabrizio Doricchi
- Dipartimento di Psicologia 39, Sapienza Università di Roma, 00185 Roma, Italy
- Laboratorio di Neuropsicologia dell’Attenzione, Fondazione Santa Lucia IRCCS, Neurorehabilitation Hospital, 00179 Roma, Italy
| | - Mario Pinto
- Dipartimento di Psicologia 39, Sapienza Università di Roma, 00185 Roma, Italy
- Laboratorio di Neuropsicologia dell’Attenzione, Fondazione Santa Lucia IRCCS, Neurorehabilitation Hospital, 00179 Roma, Italy
| | - Michele Pellegrino
- Dipartimento di Psicologia 39, Sapienza Università di Roma, 00185 Roma, Italy
- Laboratorio di Neuropsicologia dell’Attenzione, Fondazione Santa Lucia IRCCS, Neurorehabilitation Hospital, 00179 Roma, Italy
| | - Fabio Marson
- Fondazione Patrizio Paoletti—06081 Assisi, Perugia, Italy
| | | | - Serena Campana
- Auxilium Vitae—Neurorehabilitation Hospital, 56048 Volterra (Pisa), Italy
| | - Francesco Tomaiuolo
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, 98122 Messina, Italy
| | - Stefano Lasaponara
- Dipartimento di Psicologia 39, Sapienza Università di Roma, 00185 Roma, Italy
- Laboratorio di Neuropsicologia dell’Attenzione, Fondazione Santa Lucia IRCCS, Neurorehabilitation Hospital, 00179 Roma, Italy
- Dipartimento di Scienze Umane, Libera Università Maria Santissima Assunta—LUMSA, 00193 Roma, Italy
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9
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Friedrich P, Forkel SJ, Thiebaut de Schotten M. Mapping the principal gradient onto the corpus callosum. Neuroimage 2020; 223:117317. [PMID: 32882387 PMCID: PMC7116113 DOI: 10.1016/j.neuroimage.2020.117317] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/31/2020] [Accepted: 08/26/2020] [Indexed: 11/25/2022] Open
Abstract
Gradients capture some of the variance of the resting-state functional magnetic resonance imaging (rsfMRI) signal. Amongst these, the principal gradient depicts a functional processing hierarchy that spans from sensory-motor cortices to regions of the default-mode network. While the cortex has been well characterised in terms of gradients little is known about its underlying white matter. For instance, comprehensive mapping of the principal gradient on the largest white matter tract, the corpus callosum, is still missing. Here, we mapped the principal gradient onto the midsection of the corpus callosum using the 7T human connectome project dataset. We further explored how quantitative measures and variability in callosal midsection connectivity relate to the principal gradient values. In so doing, we demonstrated that the extreme values of the principal gradient are located within the callosal genu and the posterior body, have lower connectivity variability but a larger spatial extent along the midsection of the corpus callosum than mid-range values. Our results shed light on the relationship between the brain's functional hierarchy and the corpus callosum. We further speculate about how these results may bridge the gap between functional hierarchy, brain asymmetries, and evolution.
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Affiliation(s)
- Patrick Friedrich
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France; Groupe d'Imagerie Neurofonctionelle, CEA, Univ. Bordeaux, CNRS, IMN, UMR 5293, Bordeaux F-33000, France.
| | - Stephanie J Forkel
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France; Groupe d'Imagerie Neurofonctionelle, CEA, Univ. Bordeaux, CNRS, IMN, UMR 5293, Bordeaux F-33000, France; Centre for Neuroimaging Sciences, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Michel Thiebaut de Schotten
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France; Groupe d'Imagerie Neurofonctionelle, CEA, Univ. Bordeaux, CNRS, IMN, UMR 5293, Bordeaux F-33000, France
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10
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Pupil dilation during orienting of attention and conscious detection of visual targets in patients with left spatial neglect. Cortex 2020; 134:265-277. [PMID: 33310541 DOI: 10.1016/j.cortex.2020.10.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 08/27/2020] [Accepted: 10/25/2020] [Indexed: 12/18/2022]
Abstract
Right Brain-Damaged patients (RBD) with left spatial neglect (N+), are characterised by deficits in orienting and re-orienting attention to stimuli in the contralesional left side of space. In a recent ERPs study with visual stimuli (Lasaponara et al., 2018) we have pointed out that the pathological attentional bias of N+ is matched with exaggerated novelty reaction and contextual updating of targets in the right ipsilesional space and reduced novelty reaction and contextual updating of targets in the left contralesional space. To characterise further the attentional performance of N+, here we measured Pupil Dilation (PDil), which is a reliable marker of noradrenergic-locus coeruleus activity and response to unexpected events/rewards. Compared to Neutral and Valid targets, N+ patients displayed a pathological reduction of PDil in response to infrequent Invalid targets in the left side of space, while in Healthy Controls (HC) and RBD without neglect (N-) the same targets enhanced PDil with respect to Neutral and frequent Valid targets. Invalid targets in the right side of space enhanced PDil in all experimental groups. Interestingly, both N- and N+ showed a consistent number of target omissions both in the left and right side of space. With respect to seen targets, N- showed reduced PDil in response to unseen targets both in the left and right side of space. In contrast, N+ had reduced PDil in response to unseen targets in the left side of space though not in the right side, where seen and unseen targets evoked comparable levels of PDil. These results disclose, for the first time, the PDil correlates of spatial attention in left spatial neglect and suggest that the pathological attentional bias suffered by N+ might enhance the autonomic responses reflected in PDil to unseen ipsilesional stimuli. This enhancement can contribute to biasing contextual updating and predictive coding of stimuli in the ipsilesional space, thus worsening the pathological attentional bias of N+.
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11
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Sperber C, Clausen J, Benke T, Karnath HO. The anatomy of spatial neglect after posterior cerebral artery stroke. Brain Commun 2020; 2:fcaa163. [PMID: 33543137 PMCID: PMC7846084 DOI: 10.1093/braincomms/fcaa163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/10/2020] [Accepted: 09/04/2020] [Indexed: 11/14/2022] Open
Abstract
Spatial neglect is a common consequence of stroke in the territory of the right middle cerebral artery. Damage to a perisylvian fronto-temporo-parietal network has been demonstrated to underlie this disorder. Less common, stroke to the posterior cerebral artery territory may also lead to spatial neglect. This study aimed to uncover the anatomical underpinnings of spatial neglect after posterior cerebral artery infarction. A sample of 50 posterior cerebral artery infarct patients was screened for spatial neglect. Neural correlates of neglect were investigated both with voxel-based lesion behaviour mapping and with region-of-interest analyses. Brain damage neither to the splenium, nor to the parahippocampal gyrus, nor to the thalamus was predictive of spatial neglect. Only damage to the perisylvian fronto-temporo-parietal network of spatial neglect was significantly associated with neglect severity. We conclude that both posterior and middle cerebral artery stroke induce spatial neglect after damage to the same perisylvian brain network. The findings contradict previous theories that postulated neural correlates of spatial neglect specifically supplied by the posterior cerebral artery. In posterior cerebral artery stroke patients, affected parts of this network are located at the border zone between the posterior and middle cerebral artery territories. Inter-individual variability in the localization of the border between both artery territories appears to mediate the occurrence of spatial neglect after posterior cerebral artery stroke.
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Affiliation(s)
- Christoph Sperber
- Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, Centre of Neurology, University of Tübingen, 72076 Tübingen, Germany
| | - Jacob Clausen
- Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, Centre of Neurology, University of Tübingen, 72076 Tübingen, Germany
| | - Thomas Benke
- Department of Neurology, Medical University Innsbruck, A - 6020 Innsbruck, Austria
| | - Hans-Otto Karnath
- Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, Centre of Neurology, University of Tübingen, 72076 Tübingen, Germany
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
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12
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Lasaponara S, Pinto M, Scozia G, Pellegrino M, D'Onofrio M, Isabella R, Doricchi F. Pre-motor deficits in left spatial neglect: An EEG study on Contingent Negative Variation (CNV) and response-related beta oscillatory activity. Neuropsychologia 2020; 147:107572. [PMID: 32721497 DOI: 10.1016/j.neuropsychologia.2020.107572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 11/18/2022]
Abstract
Right Brain Damaged patients with left spatial neglect (N+), are characterised by poor allocation of attention in the contralesional left side of space. In a recent study (Lasaponara et al., 2018) we showed during orienting of spatial attention with endogenous central cues, both the EEG markers reflecting the early phases of orienting (Early Directing Attention Negativity) and those reflecting the late setting-up of sensory facilitation in the visual cortex (Late Directing Attention Positivity) are disturbed in N+ when these patients attend the left side of space. In the healthy brain, endogenous cues also elicit EEG activity related to the preparation of manual responses to upcoming spatial targets. Here, we wished to expand on our previous findings and investigate the EEG correlates of cue-related response preparation in N+ patients. To this aim we investigated the Contingent Negative Variation (CNV) response and the pre-motor Beta-oscillatory activity evoked by spatially informative central cues during the performance of a Posner task. Due to concomitant contralesional motor impairments, N+ an N- patients performed the task only with the ipsilesional right-hand. Compared to healthy controls and patients without neglect, N+ displayed a pathological suppression of CNV component that was independent of cue direction. In addition, the amplitude of the CNV in response to right-pointing cues was positively correlated with neglect severity in line bisection. N+ also displayed a pathological enhancement of pre-motor Beta oscillations over the left hemisphere during the time period that preceded manual responses to targets in the left side of space, particularly to invalidly cued ones. Synchronization in the Beta-band (ERS) was also correlated with lower detection rate and slower RTs to Invalid targets in the left side of space. These results provide new insights on the premotor components of the spatial orienting deficits suffered by patients with left spatial neglect and can help improving its diagnosis and rehabilitation.
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Affiliation(s)
- Stefano Lasaponara
- Dipartimento di Psicologia 39, Università degli Studi di Roma "La Sapienza", Via dei Marsi 78, 00185, Roma, Italy; Fondazione Santa Lucia, Centro Ricerche di Neuropsicologia, IRCCS, Via Ardeatina 306, 00179, Roma, Italy.
| | - Mario Pinto
- Fondazione Santa Lucia, Centro Ricerche di Neuropsicologia, IRCCS, Via Ardeatina 306, 00179, Roma, Italy
| | - Gabriele Scozia
- Dipartimento di Psicologia 39, Università degli Studi di Roma "La Sapienza", Via dei Marsi 78, 00185, Roma, Italy
| | - Michele Pellegrino
- Dipartimento di Psicologia 39, Università degli Studi di Roma "La Sapienza", Via dei Marsi 78, 00185, Roma, Italy; Fondazione Santa Lucia, Centro Ricerche di Neuropsicologia, IRCCS, Via Ardeatina 306, 00179, Roma, Italy
| | - Marianna D'Onofrio
- Dipartimento di Psicologia 39, Università degli Studi di Roma "La Sapienza", Via dei Marsi 78, 00185, Roma, Italy
| | | | - Fabrizio Doricchi
- Dipartimento di Psicologia 39, Università degli Studi di Roma "La Sapienza", Via dei Marsi 78, 00185, Roma, Italy; Fondazione Santa Lucia, Centro Ricerche di Neuropsicologia, IRCCS, Via Ardeatina 306, 00179, Roma, Italy
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13
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Danielsen VM, Vidal-Piñeiro D, Mowinckel AM, Sederevicius D, Fjell AM, Walhovd KB, Westerhausen R. Lifespan trajectories of relative corpus callosum thickness: Regional differences and cognitive relevance. Cortex 2020; 130:127-141. [PMID: 32652340 DOI: 10.1016/j.cortex.2020.05.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 05/11/2020] [Accepted: 05/25/2020] [Indexed: 02/03/2023]
Abstract
The cerebral hemispheres are specialized for different cognitive functions and receive divergent information from the sensory organs, so that the interaction between the hemispheres is a crucial aspect of perception and cognition. At the same time, the major fiber tract responsible for this interaction, the corpus callosum, shows a structural development across the lifespan which is over-proportional. That is, compared to changes in overall forebrain volume, the corpus callosum shows an accentuated growth during childhood, adolescence, and early adulthood, as well as pronounced decline in older age. However, this over-proportionality of growth and decline along with potential consequences for cognition, have been largely overlooked in empirical research. In the present study we systematically address the proportionality of callosal development in a large mixed cross-sectional and longitudinal sample (1867 datasets from 1014 unique participants), covering the human lifespan (age range 4-93 years), and examine the cognitive consequences of the observed changes. Relative corpus callosum thickness was measured at 60 segments along the midsagittal surface, and lifespan trajectories were clustered to identify callosal subsections of comparable lifespan development. While confirming the expected inverted u-shaped lifespan trajectories, we also found substantial regional variation. Compared with anterior clusters, the most posterior sections exhibited an accentuated growth during development which extends well into the third decade of life, and a protracted decline in older age which is delayed by about 10 years (starting mid to late 50s). We further showed that the observed longitudinal changes in relative thickness of the mid splenium significantly mediates age-related changes in tests assessing verbal knowledge and non-verbal visual-spatial abilities across the lifespan. In summary, we demonstrate that analyzing the proportionality of callosal growth and decline offers valuable insight into lifespan development of structural connectivity between the hemispheres, and suggests consequences for the cognitive development of perception and cognition.
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Affiliation(s)
- V M Danielsen
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Norway
| | - D Vidal-Piñeiro
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Norway
| | - A M Mowinckel
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Norway
| | - D Sederevicius
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Norway
| | - A M Fjell
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Norway; Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway
| | - K B Walhovd
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Norway; Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway
| | - R Westerhausen
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Norway.
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14
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Zebhauser PT, Vernet M, Unterburger E, Brem AK. Visuospatial Neglect - a Theory-Informed Overview of Current and Emerging Strategies and a Systematic Review on the Therapeutic Use of Non-invasive Brain Stimulation. Neuropsychol Rev 2019; 29:397-420. [PMID: 31748841 PMCID: PMC6892765 DOI: 10.1007/s11065-019-09417-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 09/27/2019] [Indexed: 01/12/2023]
Abstract
Visuospatial neglect constitutes a supramodal cognitive deficit characterized by reduction or loss of spatial awareness for the contralesional space. It occurs in over 40% of right- and 20% of left-brain-lesioned stroke patients with lesions located mostly in parietal, frontal and subcortical brain areas. Visuospatial neglect is a multifaceted syndrome - symptoms can be divided into sensory, motor and representational neglect - and therefore requires an individually adapted diagnostic and therapeutic approach. Several models try to explain the origins of visuospatial neglect, of which the "interhemispheric rivalry model" is strongly supported by animal and human research. This model proposes that allocation of spatial attention is balanced by transcallosal inhibition and both hemispheres compete to direct attention to the contralateral hemi-space. Accordingly, a brain lesion causes an interhemispheric imbalance, which may be re-installed by activation of lesioned, or deactivation of unlesioned (over-activated) brain areas through noninvasive brain stimulation. Research in larger patient samples is needed to confirm whether noninvasive brain stimulation can improve long-term outcomes and whether these also affect activities of daily living and discharge destination.
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Affiliation(s)
- Paul Theo Zebhauser
- Department of Neuropsychology, Max-Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804, Munich, Germany
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar der Technischen Universität, Munich, Germany
| | - Marine Vernet
- Section on Neurocircuitry, Laboratory of Brain and Cognition, NIMH/NIH, Bethesda, MD, USA
| | - Evelyn Unterburger
- Division of Neuropsychology, Universitätsklinik Zürich USZ, Frauenklinikstrasse 26, Zurich, Switzerland
| | - Anna-Katharine Brem
- Department of Neuropsychology, Max-Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804, Munich, Germany.
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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15
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Tomaiuolo F, Campana S, Cecchetti L, Galli R, Zucco GM, Lasaponara S, Doricchi F. Concomitant recovery from left spatial neglect and inflammatory dysfunction of white-matter pathways in a case of acute disseminated encephalo-myelitis (ADEM). Cortex 2019; 119:231-236. [PMID: 31158559 DOI: 10.1016/j.cortex.2019.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 02/13/2019] [Accepted: 04/22/2019] [Indexed: 10/26/2022]
Abstract
Spatial neglect is an invalidating neuropsychological syndrome characterized by the inability of paying attention to the side of space contralateral to a unilateral brain damage. Recent studies have suggested that lesion of white-matter pathways plays an important role in producing spatial neglect by causing a widespread functional breakdown of the network of cortical and subcortical structures that regulates orienting of spatial attention. Nonetheless, this conclusion is largely based on the study of patients who suffer combined grey and white matter damage and should be better corroborated by the study of cases with selective or predominant white matter dysfunction. Here, we describe the clinical and MRI follow-up of a patient who suffered left spatial neglect due to inflammatory Acute Disseminated Encephalo-Myelitis (ADEM) that affected the white matter. Recovery from neglect was matched with recovery from inflammatory white-matter dysfunction, despite a concomitant and progressive increase in cortical atrophy and ventricular dilatation. These findings confirm the role of white matter lesion/dysfunction in the pathogenesis of left spatial neglect.
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Affiliation(s)
| | - Serena Campana
- Unità Gravi Cerebrolesioni Acquisite, Auxilium Vitae Volterra, Pisa, Italy; La Sapienza University, Rome, Italy
| | - Luca Cecchetti
- MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Rosita Galli
- Unità Gravi Cerebrolesioni Acquisite, Auxilium Vitae Volterra, Pisa, Italy; U.O.C. Neurologia-Neurofisiopatologia, Italy
| | - Gesualdo M Zucco
- Dipartimento di Psicologia Generale, Università di Padova, Italy
| | - Stefano Lasaponara
- La Sapienza University, Rome, Italy; IRCCS "Fondazione Santa Lucia", Rome, Italy
| | - Fabrizio Doricchi
- La Sapienza University, Rome, Italy; IRCCS "Fondazione Santa Lucia", Rome, Italy
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16
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Abstract
With injury of the anterior two-thirds of the corpus callosum, each hemisphere's attentional bias to contralateral hemispace becomes manifest with each hand deviating ipsilaterally during line bisection tasks. Patients with infarctions in the right posterior cerebral artery distribution with occipital and splenial damage can also exhibit spatial neglect. The goal of this report is to learn the role of the splenium of the corpus callosum in mediating visuospatial attention. A right-handed woman with Marchiafava-Bignami disease and damage to the splenium of her corpus callosum without evidence of a mesial frontal, parietal, or occipital injury was assessed for spatial neglect with line bisections. When bisecting lines in her left hemispace with her right hand, she deviated to the right, but revealed no major deviations when the line was place in the midline, in right hemispace, or when bisecting lines with her left hand. This patient provides evidence that damage to the splenium can induce a special form of asymmetrical spatial neglect. This asymmetry might be related to the disconnected right hemisphere's ability to allocate attention to both right and left hemispaces with the disconnected left hemisphere's ability to allocate attention to the right but not left hemispace.
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Affiliation(s)
- Tigran Kesayan
- a Department of Neurology , University of South Florida Morsani College of Medicine , Tampa , FL , USA.,b Department of Neurology , James A. Haley Veteran's Affairs Hospital , Tampa , FL , USA
| | - Hamlet Gasoyan
- c College of Public Health , Temple University , Philadelphia , PA , USA
| | - Kenneth M Heilman
- d Neurology Service and GRECC , Malcom Randall Veterans Affairs Medical Center , Gainesville , FL , USA.,e Department of Neurology , University of Florida College of Medicine , Gainesville , FL , USA
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17
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Martín-Arévalo E, Schintu S, Farnè A, Pisella L, Reilly KT. Adaptation to Leftward Shifting Prisms Alters Motor Interhemispheric Inhibition. Cereb Cortex 2018; 28:528-537. [PMID: 27993820 PMCID: PMC6248503 DOI: 10.1093/cercor/bhw386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 11/15/2016] [Accepted: 11/17/2016] [Indexed: 11/14/2022] Open
Abstract
Adaptation to rightward shifting prisms (rightward prism adaptation, RPA) ameliorates neglect symptoms in patients while adaptation to leftward shifting prisms (leftward prism adaptation, LPA) induces neglect-like behaviors in healthy subjects. It has been hypothesized that prism adaptation (PA) modulates interhemispheric balance between the parietal cortices by inhibiting the posterior parietal cortex (PPC) contralateral to the prismatic deviation, but PA's effects on interhemispheric inhibition (IHI) have not been directly investigated. Since there are hyper-excitable connections between the PPC and primary motor cortex (M1) in the left hemisphere of neglect patients, we reasoned that LPA might mimic right hemisphere lesions by reducing parietal IHI, hyper-exciting the left PPC and PPC-M1 connections, and in turn altering IHI at the motor level. Namely, we hypothesized that LPA would increase IHI from the left to the right M1. We examined changes in left-to-right and right-to-left IHI between the 2 M1s using the ipsilateral silent period (iSP) (Meyer et al. 1995) before and after either LPA or RPA. The iSP was significantly longer after LPA but only from left-to-right and it did not change at all after RPA. This is the first physiological demonstration that LPA alters IHI in the healthy brain.
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Affiliation(s)
- Elisa Martín-Arévalo
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
| | - Selene Schintu
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
- Behavioral Neurology Unit, National Institute of
Neurological Disorders and Stroke, National Institutes of Health,
10 Center Bethesda, MD, USA
| | - Alessandro Farnè
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
- Hospices Civils de Lyon, Neuro-immersion & Mouvement
et Handicap, F-69676 Lyon, France
| | - Laure Pisella
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
| | - Karen T Reilly
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
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18
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Dodd KC, Nair VA, Prabhakaran V. Role of the Contralesional vs. Ipsilesional Hemisphere in Stroke Recovery. Front Hum Neurosci 2017; 11:469. [PMID: 28983244 PMCID: PMC5613154 DOI: 10.3389/fnhum.2017.00469] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 09/07/2017] [Indexed: 11/13/2022] Open
Abstract
Following a stroke, the resulting lesion creates contralateral motor impairment and an interhemispheric imbalance involving hyperexcitability of the contralesional hemisphere. Neuronal reorganization may occur on both the ipsilesional and contralesional hemispheres during recovery to regain motor functionality and therefore bilateral activation for the hemiparetic side is often observed. Although ipsilesional hemispheric reorganization is traditionally thought to be most important for successful recovery, definitive conclusions into the role and importance of the contralesional motor cortex remain under debate. Through examining recent research in functional neuroimaging investigating motor cortex changes post-stroke, as well as brain-computer interface (BCI) and transcranial magnetic stimulation (TMS) therapies, this review attempts to clarify the contributions of each hemisphere toward recovery. Several functional magnetic resonance imaging studies suggest that continuation of contralesional hemisphere hyperexcitability correlates with lesser recovery, however a subset of well-recovered patients demonstrate contralesional motor activity and show decreased functional capability when the contralesional hemisphere is inhibited. BCI therapy may beneficially activate either the contralesional or ipsilesional hemisphere, depending on the study design, for chronic stroke patients who are otherwise at a functional plateau. Repetitive TMS used to excite the ipsilesional motor cortex or inhibit the contralesional hemisphere has shown promise in enhancing stroke patients' recovery.
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Affiliation(s)
- Keith C Dodd
- Department of Biomedical Engineering, University of Wisconsin-MadisonMadison, WI, United States
| | - Veena A Nair
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-MadisonMadison, WI, United States
| | - Vivek Prabhakaran
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-MadisonMadison, WI, United States.,Medical Scientist Training Program, School of Medicine and Public Health, University of Wisconsin-MadisonMadison, WI, United States.,Neuroscience Training Program, University of Wisconsin-MadisonMadison, WI, United States.,Department of Neurology, University of Wisconsin-MadisonMadison, WI, United States.,Department of Psychology and Department of Psychiatry, University of Wisconsin-MadisonMadison, WI, United States
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19
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Complexity vs. unity in unilateral spatial neglect. Rev Neurol (Paris) 2017; 173:440-450. [DOI: 10.1016/j.neurol.2017.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/20/2017] [Accepted: 07/21/2017] [Indexed: 11/16/2022]
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20
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Lunven M, Bartolomeo P. Attention and spatial cognition: Neural and anatomical substrates of visual neglect. Ann Phys Rehabil Med 2017; 60:124-129. [DOI: 10.1016/j.rehab.2016.01.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 01/06/2016] [Accepted: 01/06/2016] [Indexed: 11/15/2022]
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21
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Gomes D, Fonseca M, Garrotes M, Lima MR, Mendonça M, Pereira M, Lourenço M, Oliveira E, Lavrador JP. Corpus Callosum and Neglect Syndrome: Clinical Findings After Meningioma Removal and Anatomical Review. J Neurosci Rural Pract 2017; 8:101-106. [PMID: 28149091 PMCID: PMC5225689 DOI: 10.4103/0976-3147.193549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Two types of neglect are described: hemispatial and motivational neglect syndromes. Neglect syndrome is a neurophysiologic condition characterized by a malfunction in one hemisphere of the brain, resulting in contralateral hemispatial neglect in the absence of sensory loss and the right parietal lobe lesion being the most common anatomical site leading to it. In motivational neglect, the less emotional input is considered from the neglected side where anterior cingulate cortex harbors the most frequent lesions. Nevertheless, there are reports of injuries in the corpus callosum (CC) causing hemispatial neglect syndrome, particularly located in the splenium. It is essential for a neurosurgeon to recognize this clinical syndrome as it can be either a primary manifestation of neurosurgical pathology (tumor, vascular lesion) or as a postoperative iatrogenic clinical finding. The authors report a postoperative hemispatial neglect syndrome after a falcotentorial meningioma removal that recovered 10 months after surgery and performs a clinical, anatomical, and histological review centered in CC as key agent in neglect syndrome.
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Affiliation(s)
- David Gomes
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal
| | | | - Maria Garrotes
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal
| | - Maria Rita Lima
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal
| | - Marta Mendonça
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal
| | - Mariana Pereira
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal
| | - Miguel Lourenço
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal
| | - Edson Oliveira
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal; Department of Neurosurgical, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - José Pedro Lavrador
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal; Department of Neurosurgical, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal; Department of Paediatric and Adult Neurosurgery, King's College Hospital NHS Foundation Trust, Denmark Hill, London
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22
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Let thy left brain know what thy right brain doeth: Inter-hemispheric compensation of functional deficits after brain damage. Neuropsychologia 2016; 93:407-412. [DOI: 10.1016/j.neuropsychologia.2016.06.016] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 05/06/2016] [Accepted: 06/12/2016] [Indexed: 12/18/2022]
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23
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Yi YG, Chun MH, Do KH, Sung EJ, Kwon YG, Kim DY. The Effect of Transcranial Direct Current Stimulation on Neglect Syndrome in Stroke Patients. Ann Rehabil Med 2016; 40:223-9. [PMID: 27152271 PMCID: PMC4855115 DOI: 10.5535/arm.2016.40.2.223] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/20/2015] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To examine whether transcranial direct current stimulation (tDCS) applied over the posterior parietal cortex (PPC) improves visuospatial attention in stroke patients with left visuospatial neglect. METHODS Patients were randomly assigned to 1 of 3 treatment groups: anodal tDCS over the right PPC, cathodal tDCS over the left PPC, or sham tDCS. Each patient underwent 15 sessions of tDCS (5 sessions per week for 3 weeks; 2 mA for 30 minutes in each session). Outcome measures were assessed before treatment and 1 week after completing the treatment. RESULTS From pre- to post-treatment, there was an improvement in the motor-free visual perception test (MVPT), line bisection test (LBT), star cancellation test (SCT), Catherine Bergego Scale (CBS), Korean version of Modified Barthel Index (K-MBI), and Functional Ambulation Classification in all 3 groups. Improvements in the MVPT, SCT, and LBT were greater in the anodal and cathodal groups than in the sham group. However, improvements in other outcomes were not significantly different between the 3 groups, although there was a tendency for improved CBS or K-MBI scores in the anodal and cathodal groups, as compared with the sham group. CONCLUSION The study results indicated that the facilitatory effect of anodal tDCS applied over the right PPC, and the inhibitory effect of cathodal tDCS applied over the left PPC, improved symptoms of visuospatial neglect. Thus, tDCS could be a successful adjuvant therapeutic modality to recover neglect symptom, but this recovery might not lead to improvements in activities of daily living function and gait function.
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Affiliation(s)
- You Gyoung Yi
- Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Ho Chun
- Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Hee Do
- Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Jung Sung
- Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong Gyu Kwon
- Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae Yul Kim
- Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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24
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Semiology of neglect: An update. Ann Phys Rehabil Med 2016; 60:177-185. [PMID: 27103056 DOI: 10.1016/j.rehab.2016.03.003] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 03/21/2016] [Accepted: 03/21/2016] [Indexed: 11/21/2022]
Abstract
Hemispatial neglect is a common disabling condition following brain damage to the right hemisphere. Generally, it involves behavioral bias directed ipsilaterally to the damaged hemisphere and loss of spatial awareness for the contralesional side. In this syndrome, several clinical subtypes were identified. The objective of this article is to provide a nosological analysis of the recent data from the literature on the different subtypes of neglect (visual, auditory, somatosensory, motor, egocentric, allocentric and representational neglect), associated ipsilesional and contralesional productive manifestations and their anatomical lesion correlates. These different anatomical-clinical subtypes can be associated or dissociated. They reflect the heterogeneity of this unilateral neglect syndrome that cannot be approached or interpreted in a single manner. We propose that these subtypes result from different underlying deficits: exogenous attentional deficit (visual, auditory neglect); representational deficit (personal neglect, representational neglect, hyperschematia); shift of the egocentric reference frame (egocentric neglect); attentional deficit between objects and within objects (allocentric neglect), endogenous attentional deficit (representational neglect) and transsaccadic working memory or spatial remapping deficit (ipsilesional productive manifestations). Taking into account the different facets of the unilateral neglect syndrome should promote the development of more targeted cognitive rehabilitation protocols.
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25
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Hemispatial neglect secondary to a traumatic brain injury. NEUROLOGÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.nrleng.2013.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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26
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Yang W, Liu TT, Song XB, Zhang Y, Li ZH, Cui ZH, Hao Q, Liu HL, Lei CL, Liu J. Comparison of different stimulation parameters of repetitive transcranial magnetic stimulation for unilateral spatial neglect in stroke patients. J Neurol Sci 2015; 359:219-25. [DOI: 10.1016/j.jns.2015.08.1541] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 08/20/2015] [Accepted: 08/27/2015] [Indexed: 11/28/2022]
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27
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Bagattini C, Mele S, Brignani D, Savazzi S. No causal effect of left hemisphere hyperactivity in the genesis of neglect-like behavior. Neuropsychologia 2015; 72:12-21. [DOI: 10.1016/j.neuropsychologia.2015.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 04/07/2015] [Accepted: 04/08/2015] [Indexed: 10/23/2022]
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28
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Lunven M, Thiebaut De Schotten M, Bourlon C, Duret C, Migliaccio R, Rode G, Bartolomeo P. White matter lesional predictors of chronic visual neglect: a longitudinal study. ACTA ACUST UNITED AC 2015; 138:746-60. [PMID: 25609686 DOI: 10.1093/brain/awu389] [Citation(s) in RCA: 155] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Chronic visual neglect prevents brain-damaged patients from returning to an independent and active life. Detecting predictors of persistent neglect as early as possible after the stroke is therefore crucial to plan the relevant interventions. Neglect signs do not only depend on focal brain lesions, but also on dysfunction of large-scale brain networks connected by white matter bundles. We explored the relationship between markers of axonal degeneration occurring after the stroke and visual neglect chronicity. A group of 45 patients with unilateral strokes in the right hemisphere underwent cognitive testing for neglect twice, first at the subacute phase (<3 months after onset) and then at the chronic phase (>1 year). For each patient, magnetic resonance imaging including diffusion sequences was performed at least 4 months after the stroke. After masking each patient's lesion, we used tract-based spatial statistics to obtain a voxel-wise statistical analysis of the fractional anisotropy data. Twenty-seven patients had signs of visual neglect at initial testing. Only 10 of these patients had recovered from neglect at follow-up. When compared with patients without neglect, the group including all subacute neglect patients had decreased fractional anisotropy in the second (II) and third (III) branches of the right superior longitudinal fasciculus, as well as in the splenium of the corpus callosum. The subgroup of chronic patients showed reduced fractional anisotropy in a portion the splenium, the forceps major, which provides interhemispheric communication between regions of the occipital lobe and of the superior parietal lobules. The severity of neglect correlated with fractional anisotropy values in superior longitudinal fasciculus II/III for subacute patients and in its caudal portion for chronic patients. Our results confirm a key role of fronto-parietal disconnection in the emergence and chronic persistence of neglect, and demonstrate an implication of caudal interhemispheric disconnection in chronic neglect. Splenial disconnection may prevent fronto-parietal networks in the left hemisphere from resolving the activity imbalance with their right hemisphere counterparts, thus leading to persistent neglect.
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Affiliation(s)
- Marine Lunven
- 1 INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), F-75013 Paris, France 2 Service de Médecine Physique et Réadaptation, Unité de Rééducation Neurologique CRF 'Les Trois Soleils' Boissise le Roi, France 3 Inserm UMR_S 1028, CNRS UMR 5292, ImpAct, centre des neurosciences de Lyon, université Lyon-1, 16, avenue Lépine 69676 Bron, France
| | - Michel Thiebaut De Schotten
- 1 INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), F-75013 Paris, France 4 Natbrainlab, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, UK
| | - Clémence Bourlon
- 2 Service de Médecine Physique et Réadaptation, Unité de Rééducation Neurologique CRF 'Les Trois Soleils' Boissise le Roi, France
| | - Christophe Duret
- 2 Service de Médecine Physique et Réadaptation, Unité de Rééducation Neurologique CRF 'Les Trois Soleils' Boissise le Roi, France
| | - Raffaella Migliaccio
- 1 INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), F-75013 Paris, France 5 AP-HP, Department of Neurology, IFR 70, Salpêtrière Hospital, Paris, France
| | - Gilles Rode
- 3 Inserm UMR_S 1028, CNRS UMR 5292, ImpAct, centre des neurosciences de Lyon, université Lyon-1, 16, avenue Lépine 69676 Bron, France 6 Service de médecine physique et réadaptation neurologique, hospital Henry-Gabrielle, hospice civils de Lyon, 20, route de Vourles, Saint-Genis-Laval, France
| | - Paolo Bartolomeo
- 1 INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), F-75013 Paris, France 5 AP-HP, Department of Neurology, IFR 70, Salpêtrière Hospital, Paris, France 7 Department of Psychology, Catholic University, Milan, Italy
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Moreh E, Malkinson TS, Zohary E, Soroker N. Visual Memory in Unilateral Spatial Neglect: Immediate Recall versus Delayed Recognition. J Cogn Neurosci 2014; 26:2155-70. [DOI: 10.1162/jocn_a_00603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract
Patients with unilateral spatial neglect (USN) often show impaired performance in spatial working memory tasks, apart from the difficulty retrieving “left-sided” spatial data from long-term memory, shown in the “piazza effect” by Bisiach and colleagues. This study's aim was to compare the effect of the spatial position of a visual object on immediate and delayed memory performance in USN patients. Specifically, immediate verbal recall performance, tested using a simultaneous presentation of four visual objects in four quadrants, was compared with memory in a later-provided recognition task, in which objects were individually shown at the screen center. Unlike healthy controls, USN patients showed a left-side disadvantage and a vertical bias in the immediate free recall task (69% vs. 42% recall for right- and left-sided objects, respectively). In the recognition task, the patients correctly recognized half of “old” items, and their correct rejection rate was 95.5%. Importantly, when the analysis focused on previously recalled items (in the immediate task), no statistically significant difference was found in the delayed recognition of objects according to their original quadrant of presentation. Furthermore, USN patients were able to recollect the correct original location of the recognized objects in 60% of the cases, well beyond chance level. This suggests that the memory trace formed in these cases was not only semantic but also contained a visuospatial tag. Finally, successful recognition of objects missed in recall trials points to formation of memory traces for neglected contralesional objects, which may become accessible to retrieval processes in explicit memory.
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Affiliation(s)
- Elior Moreh
- 1Hadassah Hebrew University Hospital, Jerusalem
- 2Hebrew University, Jerusalem
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30
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Lunven M, Thiebaut De Schotten M, Glize B, Migliaccio R, Jacquin-Courtois S, Cotton F, Bartolomeo P, Rode G. Effector-dependent neglect and splenial disconnection: a spherical deconvolution tractography study. Exp Brain Res 2014; 232:3727-36. [PMID: 25116649 DOI: 10.1007/s00221-014-4051-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 07/19/2014] [Indexed: 11/29/2022]
Abstract
We present the case of a patient with left homonymous hemianopia and chronic left neglect consequent to a stroke in the occipito-temporal regions of the right hemisphere. When the patient performed cancellation tasks with her right (dominant) hand, she had severe and persistent left neglect at retest 7 and 8 years after onset. However, her performance on line bisection was invariably within normal limits. Strikingly, performance on cancellation tests reverted to normal when the patient used her left hand. White matter tractography using spherical deconvolution demonstrated damage to the splenium of the corpus callosum, as well as a relative preservation of the right fronto-parietal network. Effector-dependent neglect may occur because splenial disconnection deprives the right fronto-parietal network from visual information processed by the left hemisphere. Consequently, spatial exploration reverts to normal when the patient uses her left hand, thus involving more directly the fronto-parietal attentional networks in the right-hemisphere.
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Affiliation(s)
- Marine Lunven
- Inserm UMR_S 1028, CNRS UMR 5292, ImpAct, Centre des Neurosciences de Lyon, Université Lyon-1, 16, Avenue Lépine, 69676, Bron, France,
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31
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Kraft A, Grimsen C, Kehrer S, Bahnemann M, Spang K, Prass M, Irlbacher K, Köhnlein M, Lipfert A, Brunner F, Kastrup A, Fahle M, Brandt SA. Neurological and neuropsychological characteristics of occipital, occipito-temporal and occipito-parietal infarction. Cortex 2014. [PMID: 23206528 DOI: 10.1016/j.cortex.2012.10.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Antje Kraft
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany.
| | - Cathleen Grimsen
- Department of Human Neurobiology, University of Bremen, Bremen, Germany
| | - Stefanie Kehrer
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Markus Bahnemann
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Karoline Spang
- Department of Human Neurobiology, University of Bremen, Bremen, Germany
| | - Maren Prass
- Department of Human Neurobiology, University of Bremen, Bremen, Germany
| | - Kerstin Irlbacher
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Köhnlein
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Anika Lipfert
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Freimuth Brunner
- Medical Hospital Gesundheit Nord, Klinikum Bremen Mitte, Bremen, Germany
| | - Andreas Kastrup
- Medical Hospital Gesundheit Nord, Klinikum Bremen Mitte, Bremen, Germany
| | - Manfred Fahle
- Department of Human Neurobiology, University of Bremen, Bremen, Germany; The Henry Wellcome Laboratories of Vision Sciences, City University London, London, UK
| | - Stephan A Brandt
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
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32
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Hemispatial neglect secondary to a traumatic brain injury. Neurologia 2014; 31:64-6. [PMID: 24556318 DOI: 10.1016/j.nrl.2013.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 12/17/2013] [Accepted: 12/29/2013] [Indexed: 11/21/2022] Open
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33
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Neuroanatomic pathway associated with attentional deficits after stroke. Brain Res 2014; 1544:25-32. [DOI: 10.1016/j.brainres.2013.11.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 11/26/2013] [Accepted: 11/27/2013] [Indexed: 11/20/2022]
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34
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Effect of High- and Low-Frequency Repetitive Transcranial Magnetic Stimulation on Visuospatial Neglect in Patients With Acute Stroke: A Double-Blind, Sham-Controlled Trial. Arch Phys Med Rehabil 2013; 94:803-7. [DOI: 10.1016/j.apmr.2012.12.016] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 12/04/2012] [Accepted: 12/28/2012] [Indexed: 11/19/2022]
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35
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Thiebaut de Schotten M, Tomaiuolo F, Aiello M, Merola S, Silvetti M, Lecce F, Bartolomeo P, Doricchi F. Damage to white matter pathways in subacute and chronic spatial neglect: a group study and 2 single-case studies with complete virtual "in vivo" tractography dissection. Cereb Cortex 2012; 24:691-706. [PMID: 23162045 DOI: 10.1093/cercor/bhs351] [Citation(s) in RCA: 246] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The exact anatomical localization of right hemisphere lesions that lead to left spatial neglect is still debated. The effect of confounding factors such as acute diaschisis and hypoperfusion, visual field defects, and lesion size may account for conflicting results that have been reported in the literature. Here, we present a comprehensive anatomical investigation of the gray- and white matter lesion correlates of left spatial neglect, which was run in a sample 58 patients with subacute or chronic vascular strokes in the territory of the right middle cerebral artery. Standard voxel-based correlates confirmed the role played by lesions in the posterior parietal cortex (supramarginal gyrus, angular gyrus, and temporal-parietal junction), in the frontal cortex (frontal eye field, middle and inferior frontal gyrus), and in the underlying parietal-frontal white matter. Using a new diffusion tensor imaging-based atlas of the human brain, we were able to run, for the first time, a detailed analysis of the lesion involvement of subcortical white matter pathways. The results of this analysis revealed that, among the different pathways linking parietal with frontal areas, damage to the second branch of the superior longitudinal fasciculus (SLF II) was the best predictor of left spatial neglect. The group study also revealed a subsample of patients with neglect due to focal lesion in the lateral-dorsal portion of the thalamus, which connects the premotor cortex with the inferior parietal lobule. The relevance of fronto-parietal disconnection was further supported by complete in vivo tractography dissection of white matter pathways in 2 patients, one with and the other without signs of neglect. These 2 patients were studied both in the acute phase and 1 year after stroke and were perfectly matched for age, handedness, stroke onset, lesion size, and for cortical lesion involvement. Taken together, the results of the present study support the hypothesis that anatomical disconnections leading to a functional breakdown of parietal-frontal networks are an important pathophysiological factor leading to chronic left spatial neglect. Here, we propose that different loci of SLF disconnection on the rostro-caudal axis can also be associated with disconnection of short-range white matter pathways within the frontal or parietal areas. Such different local disconnection patterns can play a role in the important clinical variability of the neglect syndrome.
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Affiliation(s)
- Michel Thiebaut de Schotten
- Natbrainlab, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, London, UK
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Migliaccio R, Agosta F, Toba MN, Samri D, Corlier F, de Souza LC, Chupin M, Sharman M, Gorno-Tempini ML, Dubois B, Filippi M, Bartolomeo P. Brain networks in posterior cortical atrophy: a single case tractography study and literature review. Cortex 2012; 48:1298-309. [PMID: 22099855 PMCID: PMC4813795 DOI: 10.1016/j.cortex.2011.10.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Revised: 04/01/2011] [Accepted: 10/05/2011] [Indexed: 02/07/2023]
Abstract
Posterior cortical atrophy (PCA) is rare neurodegenerative dementia, clinically characterized by a progressive decline in higher-visual object and space processing. After a brief review of the literature on the neuroimaging in PCA, here we present a study of the brain structural connectivity in a patient with PCA and progressive isolated visual and visuo-motor signs. Clinical and cognitive data were acquired in a 58-years-old patient (woman, right-handed, disease duration 18 months). Brain structural and diffusion tensor (DT) magnetic resonance imaging (MRI) were obtained. A voxel-based morphometry (VBM) study was performed to explore the pattern of gray matter (GM) atrophy, and a fully automatic segmentation was assessed to obtain the hippocampal volumes. DT MRI-based tractography was used to assess the integrity of long-range white matter (WM) pathways in the patient and in six sex- and age-matched healthy subjects. This PCA patient had a clinical syndrome characterized by left visual neglect, optic ataxia, and left limb apraxia, as well as mild visuo-spatial episodic memory impairment. VBM study showed bilateral posterior GM atrophy with right predominance; DT MRI tractography demonstrated WM damage to the right hemisphere only, including the superior and inferior longitudinal fasciculi and the inferior fronto-occipital fasciculus, as compared to age-matched controls. The homologous left-hemisphere tracts were spared. No difference was found between left and right hippocampal volumes. These data suggest that selective visuo-spatial deficits typical of PCA might not result from cortical damage alone, but by a right-lateralized network-level dysfunction including WM damage along the major visual pathways.
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Affiliation(s)
- Raffaella Migliaccio
- Inserm-UPMC UMRS 975, CR-ICM, Centre de Recherche de l’Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié-Salpêtrière, Paris, France
- Department of Psychology, Catholic University, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, INSPE, Division of Neuroscience, Scientific Institute and University Ospedale San Raffaele, Milan, Italy
| | - Monica N. Toba
- Inserm-UPMC UMRS 975, CR-ICM, Centre de Recherche de l’Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Dalila Samri
- Inserm-UPMC UMRS 975, CR-ICM, Centre de Recherche de l’Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Fabian Corlier
- Inserm-UPMC UMRS 975, CR-ICM, Centre de Recherche de l’Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Leonardo C. de Souza
- Inserm-UPMC UMRS 975, CR-ICM, Centre de Recherche de l’Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Marie Chupin
- Inserm-UPMC UMRS 975, CR-ICM, Centre de Recherche de l’Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié-Salpêtrière, Paris, France
- CNRS, UMR-S7225, Paris, France
| | - Michael Sharman
- Inserm-UPMC UMRS 975, CR-ICM, Centre de Recherche de l’Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié-Salpêtrière, Paris, France
- CENIR, Centre de Neuroimagerie de Recherche, Paris, France
| | | | - Bruno Dubois
- Inserm-UPMC UMRS 975, CR-ICM, Centre de Recherche de l’Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Massimo Filippi
- Neuroimaging Research Unit, INSPE, Division of Neuroscience, Scientific Institute and University Ospedale San Raffaele, Milan, Italy
| | - Paolo Bartolomeo
- Inserm-UPMC UMRS 975, CR-ICM, Centre de Recherche de l’Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié-Salpêtrière, Paris, France
- Department of Psychology, Catholic University, Milan, Italy
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Rode G, Cotton F, Revol P, Jacquin-Courtois S, Rossetti Y, Bartolomeo P. Representation and disconnection in imaginal neglect. Neuropsychologia 2010; 48:2903-11. [PMID: 20621588 DOI: 10.1016/j.neuropsychologia.2010.05.032] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Revised: 05/01/2010] [Accepted: 05/28/2010] [Indexed: 10/19/2022]
Abstract
Patients with neglect failure to detect, orient, or respond to stimuli from a spatially confined region, usually on their left side. Often, the presence of perceptual input increases left omissions, while sensory deprivation decreases them, possibly by removing attention-catching right-sided stimuli (Bartolomeo, 2007). However, such an influence of visual deprivation on representational neglect was not observed in patients while they were imagining a map of France (Rode et al., 2007). Therefore, these patients with imaginal neglect either failed to generate the left side of mental images (Bisiach & Luzzatti, 1978), or suffered from a co-occurrence of deficits in automatic (bottom-up) and voluntary (top-down) orienting of attention. However, in Rode et al.'s experiment visual input was not directly relevant to the task; moreover, distraction from visual input might primarily manifest itself when representation guides somatomotor actions, beyond those involved in the generation and mental exploration of an internal map (Thomas, 1999). To explore these possibilities, we asked a patient with right hemisphere damage, R.D., to explore visual and imagined versions of a map of France in three conditions: (1) 'imagine the map in your mind' (imaginal); (2) 'describe a real map' (visual); and (3) 'list the names of French towns' (propositional). For the imaginal and visual conditions, verbal and manual pointing responses were collected; the task was also given before and after mental rotation of the map by 180 degrees . R.D. mentioned more towns on the right side of the map in the imaginal and visual conditions, but showed no representational deficit in the propositional condition. The rightward inner exploration bias in the imaginal and visual conditions was similar in magnitude and was not influenced by mental rotation or response type (verbal responses or manual pointing to locations on a map), thus suggesting that the representational deficit was robust and independent of perceptual input in R.D. Structural and diffusion MRI demonstrated damage to several white matter tracts in the right hemisphere and to the splenium of corpus callosum. A second right-brain damaged patient (P.P.), who showed signs of visual but not imaginal neglect, had damage to the same intra-hemispheric tracts, but the callosal connections were spared. Imaginal neglect in R.D. may result from fronto-parietal dysfunction impairing orientation towards left-sided items and posterior callosal disconnection preventing the symmetrical processing of spatial information from long-term memory.
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Affiliation(s)
- G Rode
- Université de Lyon, Université Lyon 1, INSERM-UMRS 534, Bron, France.
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