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Terruzzi S, Albini F, Massetti G, Etzi R, Gallace A, Vallar G. The Neuropsychological Assessment of Unilateral Spatial Neglect Through Computerized and Virtual Reality Tools: A Scoping Review. Neuropsychol Rev 2024; 34:363-401. [PMID: 36913099 PMCID: PMC10009867 DOI: 10.1007/s11065-023-09586-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 09/28/2022] [Indexed: 03/14/2023]
Abstract
Unilateral Spatial Neglect is a disabling neuropsychological deficit. Patients with spatial neglect fail to detect and report events, and to perform actions in the side of space contralateral to a hemispheric cerebral lesion. Neglect is assessed by evaluating the patients' abilities in daily life activities and by psychometric tests. Computer-based, portable and Virtual Reality technologies may provide more and precise data, and be more sensitive and informative, compared to current paper-and-pencil procedures. Studies since 2010, in which such technologies have been used, are reviewed. Forty-two articles meeting inclusion criteria are categorized according to their technological approaches (computer-, graphics tablet or tablet-, virtual reality-based assessment, and other). The results are promising. However, a definite golden standard, technologically based procedure cannot be still established. Developing technologically based tests is a laborious process, which requires technical and user experience improvements as well as normative data, to increase the evidence of efficacy for clinical evaluation of at least some of the tests considered in this review.
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Affiliation(s)
- Stefano Terruzzi
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy.
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy.
- Neurocognitive Rehabilitation Center (CeRiN), University of Trento, Rovereto, Italy.
| | - Federica Albini
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Gemma Massetti
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Roberta Etzi
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Alberto Gallace
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Vallar
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy.
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy.
- Neuropsychological Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Auxologico Italiano, Milan, Italy.
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Moore MJ, Byrne J, Gibson EC, Ford L, Robinson GA. Hayling and stroop tests tap dissociable deficits and network-level neural correlates. Brain Struct Funct 2024; 229:879-896. [PMID: 38478051 PMCID: PMC11004053 DOI: 10.1007/s00429-024-02767-7] [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: 03/06/2023] [Accepted: 01/24/2024] [Indexed: 04/10/2024]
Abstract
Although many executive function screens have been developed, it is not yet clear whether these assessments are equally effective in detecting post-stroke deficits of initiation and inhibition. This study presents a comparative analysis of the Stroop and Hayling tests aiming to evaluate whether these tests measure the same underlying cognitive functions and to identify the neural correlates of the deficits detected by both tasks. Sixty six stroke survivors and 70 healthy ageing controls completed the Hayling and Stroop tests. Stroke patients were found to exhibit qualitative performance differences across analogous Stroop and Hayling Test metrics intended to tap initiation and inhibition. The Stroop test was found to have high specificity to abnormal performance, but low sensitivity relative to the Hayling Test. Minimal overlap was present between the network-level correlates of analogous Stroop and Hayling Test metrics. Hayling Task strategy use metrics were significantly associated with distinct patterns of disconnection in stroke survivors, providing novel insight into the neural correlates of fine-grained behavioural patterns. Overall, these findings strongly suggest that the functions tapped by the Stroop and Hayling Test are both behaviourally and anatomically dissociable. The Hayling Test was found to offer improved sensitivity and detail relative to the Stroop test. This novel demonstration of the Hayling Test within the stroke population suggests that this task represents an effective measure for quantifying post-stroke initiation and inhibition deficits.
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Affiliation(s)
- Margaret Jane Moore
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia
| | - Jessica Byrne
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Emily C Gibson
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Lucy Ford
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Gail A Robinson
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia.
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia.
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Minga J, Rich T, Boukrina O, Chen P, Hreha K. Identifying Spatial Neglect in Chronic Right Hemisphere Stroke Survivors Using the RHDBank Outcomes. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:511-523. [PMID: 38181442 PMCID: PMC11000791 DOI: 10.1044/2023_jslhr-23-00285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/23/2023] [Accepted: 10/19/2023] [Indexed: 01/07/2024]
Abstract
PURPOSE The chronicity of spatial neglect (SN) and the utility of existing diagnostic measures used by speech-language pathologists remain poorly understood. In this retrospective study, we examined how the RHDBank test battery informs the identification of SN after right hemisphere brain damage (RHD) during the chronic phase of recovery. METHOD Data from 29 right hemisphere stroke survivors were extracted from the RHDBank, including SN tests, for which we performed laterality index scoring: a 51-item demographic survey, the Apples Test, the Indented Paragraph Test, and the clock drawing task from the Cognitive Linguistic Quick Test (CLQT). Two groups (SN+ and SN-) were identified using the Apples Test. A hierarchical cluster analysis explored CLQT performance clusters in association with SN, and group comparisons of demographic variables and test scores were conducted. RESULTS Ten patients were identified as having SN+ (34%) using the Apples Test. The Indented Paragraph Test and the CLQT's clock drawing test identified only two of the 20 stroke survivors with SN+. Cluster analyses showed that domain and task scores on the CLQT carried information to classify participants into SN+ and SN- in concordance with performance on the Apples Test. Participants in the SN+ cluster had moderately impaired attention and executive function skills and mildly impaired visuospatial skills. CONCLUSIONS The Apples Test differentiated SN in a group of chronic right hemisphere stroke survivors. Using multiple measures from the CLQT seemed to capture a greater range of problems than clock drawing and paragraph reading tests alone. Therefore, the RHDBank test battery as a whole-and in part the CLQT, Apples Test, and Indented Paragraph Test-can detect certain subtypes of SN in the chronic deficit profile after RHD and is a starting point for diagnostic integration by speech-language pathologists.
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Affiliation(s)
- Jamila Minga
- Department of Head and Neck Surgery & Communication Sciences and Department of Neurology, Duke University, Durham, NC
| | - Timothy Rich
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
| | - Olga Boukrina
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
| | - Peii Chen
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
| | - Kimberly Hreha
- Occupational Therapy Doctorate Division, Department of Orthopaedic Surgery, Duke University, Durham, NC
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Gurd J, Demeyere N, Moore MJ. Attentional and lexical factors underlying word-centred neglect dyslexia errors in healthy readers. Atten Percept Psychophys 2024; 86:312-325. [PMID: 37415059 PMCID: PMC10769981 DOI: 10.3758/s13414-023-02753-x] [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] [Accepted: 06/19/2023] [Indexed: 07/08/2023]
Abstract
Word-centred neglect dyslexia is most commonly conceptualised as a deficit caused by attentional biases within spatially coded internal representations of words. However, recent research has suggested that at least some cases of word-centred neglect dyslexia are unrelated to visuospatial neglect and may instead be modulated by self-inhibition and lexical factors. Here, we set out to provide novel insight into potential underlying mechanisms modulating the occurrence of word-centred lateralised reading errors in healthy participants. A sample of 47 healthy readers completed a novel attentional cueing paradigm in which they sequentially identified lateral cues and read presented words under limited exposure conditions. Reading responses were analysed to determine whether word-centred neglect dyslexia could be simulated in healthy readers, to compare the strengths of induced biases, and to identify systematic differences in lexical characteristics between target words and neglect dyslexia reading errors. Healthy participants produced frequent lateralised reading errors in both horizontal and vertical reading stimuli with > 50% of errors classed as neglect dyslexic. Cues appended to word beginnings elicited significantly more reading errors than cues at word ends, illustrating the interaction between existing reading spatial attentional biases and cue-induced biases. Neglect dyslexia reading errors were found to contain significantly more letters per word and had higher concreteness ratings than target words. These findings demonstrate that word-centred neglect dyslexia can be simulated using attentional cues in healthy readers. These results provide important insight into the mechanisms underlying word-centred neglect dyslexia and further fundamental understanding of this syndrome.
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Affiliation(s)
- James Gurd
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Margaret Jane Moore
- Department of Experimental Psychology, University of Oxford, Oxford, UK.
- Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia.
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Rich TJ, Palmer J. Neglect dyslexia: whole-word and within-word errors with parafoveal and foveal viewing. Exp Brain Res 2023; 241:2655-2668. [PMID: 37773416 PMCID: PMC10635956 DOI: 10.1007/s00221-023-06708-4] [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: 02/28/2023] [Accepted: 09/13/2023] [Indexed: 10/01/2023]
Abstract
Patients with left-sided neglect dyslexia often omit whole words positioned on the left, termed whole-word errors, or commit errors on the left-sided letters of words, termed unilateral paralexias. In addition, the errors have been shown to be exacerbated by simultaneously presented distractors, which has been interpreted as a failure of selective attention. In two experiments, we examined the dependency of these error types on parafoveal versus foveal viewing. The first experiment used a paradigm with parafoveal targets and distractors; the second a paradigm with foveal targets and parafoveal distractors. This enabled a separate evaluation of the influences of stimulus position within an egocentric frame, a two-word allocentric frame, and a within-word allocentric frame. First, regarding whole-word errors, we found the expected spatial and distractor effects with parafoveal targets and distractors. With foveal targets and parafoveal distractors, however, the spatial effect was effectively eliminated. Surprisingly, intrusions from the distractor word were common in distractor conditions. This is consistent with an egocentric account and not a two-word allocentric account. Second, we found that unilateral paralexias remained largely consistent regardless of spatial position or the presence of a distractor. Thus, there is a contrast in spatial and distractor effects between whole-word errors and unilateral paralexias. These results are consistent with three distinct deficits: an egocentric deficit across space resulting in whole-word errors, a failure of selective attention that results in whole-word intrusion errors, and a within-word allocentric deficit resulting in unilateral paralexias.
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Affiliation(s)
- Timothy J Rich
- Center for Stroke Rehabilitation Research, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ, USA.
- Department of Physical Medicine and Rehabilitation, Rutgers University, New Brunswick, NJ, USA.
| | - John Palmer
- Department of Psychology, University of Washington, Seattle, WA, USA
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Potier Watkins C, Dehaene S, Friedmann N. Characterizing different types of developmental dyslexias in French: The Malabi screener. Cogn Neuropsychol 2023; 40:319-350. [PMID: 38831527 DOI: 10.1080/02643294.2024.2327665] [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: 02/02/2023] [Accepted: 02/16/2024] [Indexed: 06/05/2024]
Abstract
Reading is a complex process involving multiple stages. An impairment in any of these stages may cause distinct types of reading deficits- distinct types of dyslexia. We describe the Malabi, a screener to identify deficits in various orthographic, lexical, and sublexical components of the reading process in French. The Malabi utilizes stimuli that are sensitive to different forms of dyslexia, including "attentional dyslexia", as it is traditionally refered to, characterized by letter-to-word binding impairments leading to letter migrations between words (e.g., "bar cat" misread as "bat car"), and "letter-position dyslexia", resulting in letter transpositions within words (e.g., "destiny" misread as "density"). After collecting reading error norms from 138 French middle-school students, we analyzed error types of 16 students with developmental dyslexia. We identified three selective cases of attentional dyslexia and one case of letter-position dyslexia. Further tests confirmed our diagnosis and demonstrate, for the first time, how these dyslexias are manifested in French. These results underscore the significance of recognizing and discussing the existence of multiple dyslexias, both in research contexts when selecting participants for dyslexia studies, and in practical settings where educators and practitioners work with students to develop personalized support. The test and supporting materials are available on Open Science Framework (https://osf.io/3pgzb/).
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Affiliation(s)
- Cassandra Potier Watkins
- Cognitive Neuroimaging Unit, CEA, INSERM, Université Paris-Saclay, NeuroSpin Center, Gif/Yvette, France
- Collège de France, Université Paris-Sciences-Lettres (PSL), Paris, France
| | - Stanislas Dehaene
- Cognitive Neuroimaging Unit, CEA, INSERM, Université Paris-Saclay, NeuroSpin Center, Gif/Yvette, France
- Collège de France, Université Paris-Sciences-Lettres (PSL), Paris, France
| | - Naama Friedmann
- Language and Brain Lab, Tel Aviv University, Tel Aviv, Israel
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Martin J, Vuilleumier P, Assal F, Ronchi R. Neglecting the bottom space: an object-based disorder? A two-case observational study. Neurocase 2023; 29:121-131. [PMID: 38406985 DOI: 10.1080/13554794.2024.2315860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024]
Abstract
Altitudinal neglect is an atypical form of spatial neglect where brain-damaged patients neglect the lower, or sometimes the upper, part of the space. Our understanding of this phenomena is limited, with unknown occurrence across different reference frames, such as distance (peripersonal vs. extrapersonal) and system of reference (egocentric vs. allocentric). Two patients with acute bilateral (P1) or right hemispheric (P2) stroke, with signs of bottom altitudinal neglect, underwent an extensive evaluation of neglect within 10 days post-stroke. Assessments involved altitudinal neglect and unilateral spatial neglect (USN) in peripersonal space, exploring egocentric and allocentric signs and in extrapersonal space. Compared to a control group of 15 healthy age-matched subjects, patients showed allocentric and egocentric left USN in peripersonal space, and mostly allocentric signs of altitudinal neglect. No signs of neglect were evidenced in extrapersonal space. Altitudinal neglect could thus present as an allocentric form of spatial neglect, suggesting that allocentric representations may not only affect the deployment of attentional resources along horizontal dimensions but also operate along vertical dimensions. Future studies should deepen our understanding of altitudinal neglect, eventually leading to further unravel spatial processes that control attention, their corresponding brain mechanisms, and implications for patients' rehabilitation and functional outcome.
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Affiliation(s)
- Jennifer Martin
- Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Patrik Vuilleumier
- Laboratory of Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
- Faculty of Medecine, University of Geneva, Geneva, Switzerland
| | - Frédéric Assal
- Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medecine, University of Geneva, Geneva, Switzerland
| | - Roberta Ronchi
- Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland
- Laboratory of Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
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Rossetto A, Toraldo A, Laratta S, Tonin P, Poletto C, Bencini G, Semenza C. Linguistic structure modulates attention in reading: Evidence from negative concord in Italian. Cogn Neuropsychol 2023; 39:356-374. [PMID: 37045801 DOI: 10.1080/02643294.2023.2199918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
We report the reading performance of an Italian speaker with egocentric Neglect Dyslexia on sentences with Negative Concord structures, which contain a linguistic cue to the presence of a preceding negative marker and compare it to sentences with no such cue. As predicted, the frequency of reading the whole sentence, including the initial negative marker non, was higher in Negative Concord structures than in sentences which also started with non, but crucially, lacked the medially positioned linguistic cue to the presence of non. These data support the claim that the presence of linguistic cues to sentence structure modulates attention during reading in Neglect Dyslexia.
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Affiliation(s)
- Alessia Rossetto
- Department of Cognitive Science, Macquarie University, Sydney, Australia
- Centre for Language and Cognition, University of Groningen, Groningen, Netherlands
- International Doctorate for Experimental Approaches to Language and Brain (IDEALAB); Macquarie University (AU), University of Groningen (NL), University of Potsdam (DE), University of Newcastle (UK)
| | - Alessio Toraldo
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
| | | | | | - Cecilia Poletto
- Department of Language and Literature, University of Padua, Padua, Italy
| | - Giulia Bencini
- Department of Linguistics and Comparative Studies, Ca' Foscari University Venice, Venice, Italy
| | - Carlo Semenza
- Padova Neuroscience Centre, University of Padua, Padua, Italy
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Moore MJ, Demeyere N. Word-centred neglect dyslexia as an inhibitional deficit: A single case study. Neuropsychologia 2023; 184:108502. [PMID: 36906224 DOI: 10.1016/j.neuropsychologia.2023.108502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 01/29/2023] [Accepted: 02/01/2023] [Indexed: 03/12/2023]
Abstract
Word-centred neglect dyslexia is most commonly characterised as consequence of visuospatial neglect rather than an independent condition. However, recent research has suggested that this deficit may be dissociable from spatial attentional biases. This study aims to provide preliminary evidence investigating alternative mechanisms which could account for cases of word-centred neglect dyslexia which cannot be explained by visuospatial neglect. Patient EF is a chronic stroke survivor who presented with clear right-lateralised word-centred neglect dyslexia in conjunction with severe left egocentric neglect and left hemianopia following a right PCA stroke. The severity of EF's neglect dyslexia was not found to be affected by factors which modulate the severity of visuospatial neglect. EF demonstrated an intact ability to identify all letters in words, but reliably committed neglect dyslexia errors when subsequently reading the same words as a whole. EF did not exhibit neglect dyslexic impairment in standardised spelling, word-meaning matching, and word-picture matching tasks. Critically, EF exhibited marked cognitive inhibition impairment and committed neglect dyslexia errors which were characterised by misreading less familiar target words as more familiar responses. This behavioural pattern cannot be clearly accounted for by theories which characterize word-centred neglect dyslexia as a consequence of neglect. Instead, this data suggests that this case of word-centred neglect dyslexia may be related to a deficit of cognitive inhibition. Overall, these novel findings call for reevaluation of the dominant model of word-centred neglect dyslexia.
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Affiliation(s)
- Margaret Jane Moore
- Queensland Brain Institute, University of Queensland, Brisbane, Australia; Department of Experimental Psychology, University of Oxford, Oxford, UK.
| | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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10
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Bahrami Balani A, Bickerton WL. Acquired reading impairment following brain injury. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-19. [PMID: 36745703 DOI: 10.1080/23279095.2023.2165923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This large-scale patient study investigated the rate, unique signatures associated with acquired reading impairments, its neurocognitive correlates, and long-term outcome in 731 acute stroke patients using the sentence and non-word reading subtests of Birmingham Cognitive Screen (BCoS). The objectives for the study were to explore the (i) potentially different error patterns among adult patients, (ii) associative relationship between the different subclasses of reading impairment and performance in other cognitive domains, and (iii) recovery rates in patients nine months post-lesion compared with their initial performance. The study revealed distinctive reading impairment profiles in patients with left hemisphere (LH) and right hemisphere (RH) lesions. Some interesting associations between reading disorder and other cognitive functions were observed. Nine months post-lesion, both groups showed some recovery in reading performance compared with their baseline performance, but the rate of improvement was higher for the LH group. The study reveals unique reading profiles and impairment patterns among left and right hemisphere lesions. The findings of the study provide a deeper understanding of reading deficits that will inform clinical practice, planning of rehabilitative interventions of brain injured patients, and the scientific community.
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Chen P, Diaz-Segarra N, Hreha K, Kaplan E, Barrett AM. Prism Adaptation Treatment Improves Inpatient Rehabilitation Outcome in Individuals With Spatial Neglect: A Retrospective Matched Control Study. Arch Rehabil Res Clin Transl 2021; 3:100130. [PMID: 34589681 PMCID: PMC8463461 DOI: 10.1016/j.arrct.2021.100130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To determine whether prism adaptation treatment (PAT) integrated into the standard of care improves rehabilitation outcome in patients with spatial neglect (SN). Design Retrospective matched control study based on information extracted from June 2017-September 2019. Setting Inpatient rehabilitation. Participants Patients from 14 rehabilitation hospitals scoring >0 on the Catherine Bergego Scale (N=312). The median age was 69.5 years, including 152 (49%) female patients and 275 (88%) patients with stroke. Interventions Patients were matched 1:1 by age (±5 years), FIM score at admission (±2 points), and SN severity using the Catherine Bergego Scale (±2 points) and classified into 2 groups: treated (8-12 daily sessions of PAT) vs untreated (no PAT). Main Outcome Measures FIM and its minimal clinically important difference (MCID) were the primary outcome variables. Secondary outcome was home discharge. Results Analysis included the 312 matched patients (156 per group). FIM scores at discharge were analyzed using repeated-measures analyses of variance. The treated group showed reliably higher scores than the untreated group in Total FIM, F=5.57, P=.020, partial η2=0.035, and Cognitive FIM, F=19.20, P<.001, partial η2=0.110, but not Motor FIM, F=0.35, P=.553, partial η2=0.002. We used conditional logistic regression to examine the odds ratio of reaching MCID in each FIM score and of returning home after discharge. No reliable difference was found between groups in reaching MCID or home discharge. Conclusions Patients with SN receiving PAT had better functional and cognitive outcomes, suggesting that integrating PAT into the standard of care is beneficial. However, receiving PAT may not determine home discharge.
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Key Words
- Brain injury
- CBS, Catherine Bergego Scale
- CMS, Centers for Medicare and Medicaid Services
- IRB, institutional review board
- KF-NAP, Kessler Foundation Neglect Assessment Process
- KF-PAT, Kessler Foundation Prism Adaptation Treatment
- LOS, length of stay
- List of abbreviations: ANOVA, analysis of variance
- MCID, minimal clinically important difference
- Neurorehabilitation
- OR, odds ratio
- OT, occupational therapist
- Outcome
- PAT, prism adaptation treatment
- RCT, randomized controlled trial
- Rehabilitation
- SN, spatial neglect
- Stroke rehabilitation
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Affiliation(s)
- Peii Chen
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ.,Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ
| | - Nicole Diaz-Segarra
- Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ.,Department of Physical Medicine and Rehabilitation, Kessler Institute for Rehabilitation, West Orange, NJ
| | - Kimberly Hreha
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX
| | - Emma Kaplan
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
| | - A M Barrett
- Department of Neurology, Emory University School of Medicine, Atlanta, GA.,Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, US Department of Veterans Affairs, Decatur, GA
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Chen P, Zanca J, Esposito E, Barrett AM. Barriers and Facilitators to Rehabilitation Care of Individuals With Spatial Neglect: A Qualitative Study of Professional Views. Arch Rehabil Res Clin Transl 2021; 3:100122. [PMID: 34179758 PMCID: PMC8212009 DOI: 10.1016/j.arrct.2021.100122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective To identify barriers and facilitators to achieving optimal inpatient rehabilitation outcome among individuals with spatial neglect (SN). Design Cross-sectional, semistructured focus group discussions. Setting Rehabilitation hospitals. Participants A total of 15 occupational therapists and 14 physical therapists treating patients with SN on 3 campuses of a rehabilitation hospital system (N=29). Six focus group sessions were conducted and audio-recorded for transcription. Interventions Not applicable. Main Outcome Measures Not applicable. Results Participants identified several patient-related characteristics that posed barriers to treatment, including the symptoms of SN itself, cognitive issues, physical weakness, comorbidities, and reduced therapy engagement. Supportive family members were considered a key facilitator, but lack of preparedness to assume caregiving roles, poor understanding of SN and rehabilitation goals, and inadequate levels of involvement were family-related barriers to successful treatment. Participants expressed that having resources and technologies available at their center to support SN treatment facilitated positive outcomes and perceived limited staff knowledge and skills and poor interclinician communication as barriers to treatment. At the health care system level, barriers included a lack of responsive measures of SN progress and insurer-related issues. Strong continuity of care between transitions was considered an important factor for enabling effective treatment. Conclusions Barriers and facilitators to the current practice of SN care were identified from occupational and physical therapists’ point of view. Opportunities exist to promote identified facilitators and minimize barriers to improve SN rehabilitation. The present study makes a unique contribution in identifying specific needs for innovative interventions that involve family support and training, promotion of interdisciplinary collaboration, development of interprofessional vocabulary, and continuous treatment and follow-up assessment for SN through care transitions.
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Affiliation(s)
- Peii Chen
- Kessler Foundation, West Orange, New Jersey, United States.,Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, New Jersey, United States
| | - Jeanne Zanca
- Kessler Foundation, West Orange, New Jersey, United States.,Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, New Jersey, United States
| | - Emily Esposito
- Department of Psychology, University of California, Riverside, California, United States
| | - A M Barrett
- Department of Neurology, Emory University, Atlanta, Georgia, United States.,Atlanta VA Health Care System, U.S. Department of Veterans Affairs, Decatur, Georgia, United States
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Daini R, Primativo S, Albonico A, Veronelli L, Malaspina M, Corbo M, Martelli M, Arduino LS. The Focal Attention Window Size Explains Letter Substitution Errors in Reading. Brain Sci 2021; 11:247. [PMID: 33669454 PMCID: PMC7920487 DOI: 10.3390/brainsci11020247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/30/2021] [Accepted: 02/12/2021] [Indexed: 11/16/2022] Open
Abstract
Acquired Neglect Dyslexia is often associated with right-hemisphere brain damage and is mainly characterized by omissions and substitutions in reading single words. Martelli et al. proposed in 2011 that these two types of error are due to different mechanisms. Omissions should depend on neglect plus an oculomotor deficit, whilst substitutions on the difficulty with which the letters are perceptually segregated from each other (i.e., crowding phenomenon). In this study, we hypothesized that a deficit of focal attention could determine a pathological crowding effect, leading to imprecise letter identification and consequently substitution errors. In Experiment 1, three brain-damaged patients, suffering from peripheral dyslexia, mainly characterized by substitutions, underwent an assessment of error distribution in reading pseudowords and a T detection task as a function of cue size and timing, in order to measure focal attention. Each patient, when compared to a control group, showed a deficit in adjusting the attentional focus. In Experiment 2, a group of 17 right-brain-damaged patients were asked to perform the focal attention task and to read single words and pseudowords as a function of inter-letter spacing. The results allowed us to confirm a more general association between substitution-type reading errors and the performance in the focal attention task.
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Affiliation(s)
- Roberta Daini
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (A.A.); (M.M.)
- COMiB—Optics and Optometry Research Center, Università degli studi di Milano-Bicocca & NeuroMI—Milan Center for Neuroscience, 20126 Milan, Italy
| | - Silvia Primativo
- Department of Human Sciences, LUMSA University, 00193 Rome, Italy; (S.P.); (L.S.A.)
| | - Andrea Albonico
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (A.A.); (M.M.)
- Departments of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC V5Z 3N9, Canada
| | - Laura Veronelli
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, 20144 Milan, Italy; (L.V.); (M.C.)
| | - Manuela Malaspina
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (A.A.); (M.M.)
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, 20144 Milan, Italy; (L.V.); (M.C.)
| | - Marialuisa Martelli
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy;
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Lisa S. Arduino
- Department of Human Sciences, LUMSA University, 00193 Rome, Italy; (S.P.); (L.S.A.)
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14
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Harvey M, Learmonth G, Rossit S, Chen P. Editorial for special issue on neglect rehabilitation. Neuropsychol Rehabil 2021; 32:629-639. [PMID: 33467990 DOI: 10.1080/09602011.2021.1873150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
It is clear already that in current and future years more people will suffer from stroke, whether related to COVID-19 or not, and given its prevalence, many more people's lives will be affected by neglect. Here we hope to have contributed to its possible amelioration with highlights of the latest thinking on neglect diagnosis, prevalence and treatment.
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Affiliation(s)
- Monika Harvey
- School of Psychology, University of Glasgow, Glasgow, UK
| | - Gemma Learmonth
- Centre for Cognitive Neuroimaging, Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | | | - Peii Chen
- Kessler Foundation, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University, New Brunswick, NJ, USA
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15
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Abstract
Alexia refers to a reading disorder caused by some form of acquired brain pathology, most commonly a stroke or tumor, in a previously literate subject. In neuropsychology, a distinction is made between central alexia (commonly seen in aphasia) and peripheral alexia (a perceptual or attentional deficit). The prototypical peripheral alexia is alexia without agraphia (pure alexia), where patients can write but are impaired in reading words and letters. Pure alexia is associated with damage to the left ventral occipitotemporal cortex (vOT) or its connections. Hemianopic alexia is associated with less extensive occipital damage and is caused by a visual field defect, which creates problems reading longer words and passages of text. Reading impairment can also arise due to attentional deficits, most commonly following right hemisphere or bilateral lesions. Studying patients with alexia, along with functional imaging studies of normal readers, has improved our understanding of the neurobiological processes involved in reading. A key question is whether an area in the left ventral occipitotemporal cortex is specialized for or selectively involved in word processing, or whether reading relies on tuning of more general purpose perceptual areas. Reading deficits may also be observed in dementia and traumatic brain injury, but often with less consistent deficit patterns than in patients with focal lesions.
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Affiliation(s)
- Randi Starrfelt
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
| | - Zoe Woodhead
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
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16
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Esposito E, Shekhtman G, Chen P. Prevalence of spatial neglect post-stroke: A systematic review. Ann Phys Rehabil Med 2020; 64:101459. [PMID: 33246185 DOI: 10.1016/j.rehab.2020.10.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/18/2020] [Accepted: 10/26/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Spatial neglect (SN) impedes stroke rehabilitation progress, slows functional recovery, and increases caregiver stress and burden. The estimation of SN prevalence varies widely across studies. BACKGROUND We aimed to establish the prevalence of SN based on the injured cerebral hemisphere, recovery stage post-stroke, and diagnostic methodology. MATERIALS AND METHODS All journal articles published up to February 27, 2019 from CINAHL, PsycINFO, PubMed and Web of Science were searched. We selected original research articles that described observational studies, included both individuals with left brain damage (LBD) and those with right brain damage (RBD) post-stroke, and reported specific diagnostic methods for SN. All authors reached consensus for the final selection of 41 articles. Time post-stroke, patient selection criteria, study setting, SN diagnostic methods were extracted. RESULTS A total of 6324 participants were included: 3411 (54%) with RBD and 2913 (46%) with LBD. Without considering time post-stroke or diagnostic methods, the occurrence rate of SN was 29% (38% after RBD and 18% after LBD). Using ecological assessments resulted in higher prevalence than using tests not directly related to daily life activities (53% vs. 24%). Using methods based on a single-cutoff criterion led to lower occurrence of SN than using multi-test methods (27% vs. 33%). The prevalence decreased from the acute to chronic stage post-stroke. CONCLUSIONS The estimated prevalence of SN after unilateral stroke is 30%. SN is more common after RBD than after LBD, but SN after LBD is still quite common. Using ecological assessments and multi-test methods to detect SN is preferred to using a single-cutoff criterion of a test that is not directly related to daily function. The decrease in SN prevalence over time is evident, but the exact prevalence in later stages cannot be estimated. More research is needed to better understand chronic SN.
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Affiliation(s)
- Emily Esposito
- Department of Psychology, University of California, Riverside, 900, University avenue, Riverside, CA, USA
| | - Grigoriy Shekhtman
- Centre for Stroke Rehabilitation Research, Kessler Foundation, 1199, Pleasant Valley Way, West Orange, NJ, USA; Department of Psychology, Seton Hall University, 400, South Orange avenue, South Orange, NJ, USA
| | - Peii Chen
- Centre for Stroke Rehabilitation Research, Kessler Foundation, 1199, Pleasant Valley Way, West Orange, NJ, USA; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, 183, South Orange avenue, Newark, NJ, USA.
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17
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Ptak R, Bourgeois A, Cavelti S, Doganci N, Schnider A, Iannotti GR. Discrete Patterns of Cross-Hemispheric Functional Connectivity Underlie Impairments of Spatial Cognition after Stroke. J Neurosci 2020; 40:6638-6648. [PMID: 32709694 PMCID: PMC7486659 DOI: 10.1523/jneurosci.0625-20.2020] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/06/2020] [Accepted: 07/04/2020] [Indexed: 12/17/2022] Open
Abstract
Despite intense research, the neural correlates of stroke-induced deficits of spatial cognition remain controversial. For example, several cortical regions and white-matter tracts have been designated as possible anatomic predictors of spatial neglect. However, many studies focused on local anatomy, an approach that does not harmonize with the notion that brain-behavior relationships are flexible and may involve interactions among distant regions. We studied in humans of either sex resting-state fMRI connectivity associated with performance in line bisection, reading and visual search, tasks commonly used for he clinical diagnosis of neglect. We defined left and right frontal, parietal, and temporal areas as seeds (or regions of interest, ROIs), and measured whole-brain seed-based functional connectivity (FC) and ROI-to-ROI connectivity in subacute right-hemisphere stroke patients. Performance on the line bisection task was associated with decreased FC between the right fusiform gyrus and left superior occipital cortex. Complementary increases and decreases of connectivity between both temporal and occipital lobes predicted reading errors. In addition, visual search deficits were associated with modifications of FC between left and right inferior parietal lobes and right insular cortex. These distinct connectivity patterns were substantiated by analyses of FC between left- and right-hemispheric ROIs, which revealed that decreased interhemispheric and right intrahemispheric FC was associated with higher levels of impairment. Together, these findings indicate that intrahemispheric and interhemispheric cooperation between brain regions lying outside the damaged area contributes to spatial deficits in a way that depends on the different cognitive components recruited during reading, spatial judgments, and visual exploration.SIGNIFICANCE STATEMENT Focal damage to the right cerebral hemisphere may result in a variety of deficits, often affecting the domain of spatial cognition. The neural correlates of these disorders have traditionally been studied with lesion-symptom mapping, but this method fails to capture the network dynamics that underlie cognitive performance. We studied functional connectivity in patients with right-hemisphere stroke and found a pattern of correlations between the left and right temporo-occipital, inferior parietal, and right insular cortex that were distinctively predictive of deficits in reading, spatial judgment, and visual exploration. This finding reveals the importance of interhemispheric interactions and network adaptations for the manifestation of spatial deficits after damage to the right hemisphere.
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Affiliation(s)
- Radek Ptak
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, 1206, Switzerland
- Division of Neurorehabilitation, University Hospitals of Geneva, Geneva, 1206, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, 1205, Switzerland
| | - Alexia Bourgeois
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, 1206, Switzerland
| | - Silvia Cavelti
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, 1206, Switzerland
| | - Naz Doganci
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, 1206, Switzerland
| | - Armin Schnider
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, 1206, Switzerland
- Division of Neurorehabilitation, University Hospitals of Geneva, Geneva, 1206, Switzerland
| | - Giannina Rita Iannotti
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, 1206, Switzerland
- Swiss Foundation for Innovation and Training in Surgery, University Hospitals of Geneva, Geneva, 1206, Switzerland
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18
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Moore MJ, Demeyere N. Dissociating spatial attention from neglect dyslexia: A single case study. Cortex 2020; 130:246-256. [PMID: 32688274 DOI: 10.1016/j.cortex.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/18/2020] [Accepted: 06/16/2020] [Indexed: 10/24/2022]
Abstract
Word-centred neglect dyslexia is generally thought to be caused by a visuospatial neglect-like attentional deficit which impacts orientation-canonical representations of visual stimuli. However, the relationship between word-centred neglect dyslexia and more general attentional processes is not well described. Here, we investigated the impact of attentional load manipulations within a case of word-centred neglect dyslexia. This study presents data from a single case, Patient CD, who exhibited ipsilesional word-centred neglect dyslexia in conjunction with severe, contralesional allocentric neglect. CD demonstrated an intact ability to name all letters in visually presented words, but committed neglect dyslexia errors when subsequently asked to read the same word as a whole. The severity of patient CD's neglect dyslexia was not found to be impacted by attentional manipulations. We found no effect of exposure time or visual crowding on the frequency of neglect dyslexia errors. This absence of an apparent, right-lateralised perceptual deficit, comorbid left-lateralised object-centred neglect, and insensitivity to attentional load manipulations suggests that the deficit underlying word-centred neglect dyslexia is not related to broad visuo-spatial attention. These findings suggest that neglect dyslexia and domain-general visuospatial neglect may not be as related as previously asserted.
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Affiliation(s)
- Margaret J Moore
- University of Oxford, Department of Experimental Psychology, Radcliffe Observatory Quarter, Oxford, United Kingdom.
| | - Nele Demeyere
- University of Oxford, Department of Experimental Psychology, Radcliffe Observatory Quarter, Oxford, United Kingdom
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19
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Jang Y, Lee E, Kim Y, Park JH. Number Processing Error as a Clinical Manifestation of Hemispatial Neglect Following Hypoxic Brain Injury: a Case Report. BRAIN & NEUROREHABILITATION 2020; 13:e20. [PMID: 36741793 PMCID: PMC9879366 DOI: 10.12786/bn.2020.13.e20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 06/26/2020] [Accepted: 07/06/2020] [Indexed: 11/08/2022] Open
Abstract
Hemispatial neglect is a symptom where patients do not show response to stimuli on the contralesional side of their brain lesion. Although it is most common in the context of hemispheric stroke, several pathological processes including neurodegenerative disease, neoplasia, and trauma may cause this. Prevalence of hemispatial neglect is unknown and rarely reported among patients with hypoxic brain injury. Also, hemispatial neglect accompanying neglect dyslexia is rather hard to be recognized and symptoms involving numbers are exceptionally rare. We report a patient with hypoxic brain injury following cardiac arrest who showed signs of neglect dyslexia for numbers that provided a primary clue for the diagnosis of left hemispatial neglect. Early detection of different forms of cognitive dysfunction of hypoxic brain injury is highly essential in providing early neurorehabilitation for better prognosis.
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Affiliation(s)
- Yongjun Jang
- Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eunji Lee
- Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youngkook Kim
- Department of Rehabilitation Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joo Hyun Park
- Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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20
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Boukrina O, Chen P, Budinoska T, Barrett A. Exploratory examination of lexical and neuroanatomic correlates of neglect dyslexia. Neuropsychology 2020; 34:404-419. [PMID: 31999167 PMCID: PMC7249258 DOI: 10.1037/neu0000619] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This study examined lexical and neuroanatomic correlates of reading errors in individuals with spatial neglect, defined as a failure to respond to stimuli in the side of space opposite a brain lesion, causing functional disability. METHOD One-hundred and ten participants with left spatial neglect after right-hemisphere stroke read aloud a list of 36 words. Reading errors were scored as "contralesional" (error in the left half of the word) or as "other." The influence of lexical processing on neglect dyslexia was studied with a stepwise regression using word frequency, orthographic neighborhood (number of same length neighbors that differ by 1 letter), bigram and trigram counts (number of words with the same 2- and 3-letter combinations), length, concreteness, and imageability as predictors. MRI/CT images of 92 patients were studied in a voxelwise lesion-symptom analysis (VLSM). RESULTS Longer length and more trigram neighbors increased, while higher concreteness reduced, the rate of contralesional errors. VLSM revealed lesions in the inferior temporal sulcus, middle temporal and angular gyri, precuneus, temporal pole, and temporo-parietal white matter associated with the rate of contralesional errors. CONCLUSIONS Orthographic competitors may decrease word salience, while semantic concreteness may help constrain the selection of available word options when it is based on degraded information from the left side of the word. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Olga Boukrina
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
- Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ
| | - Peii Chen
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
- Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ
| | - Tamara Budinoska
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
| | - A.M. Barrett
- Center for Visual & Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, GA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA
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21
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Moore MJ, Shalev N, Gillebert CR, Demeyere N. Dissociations within neglect-related reading impairments: Egocentric and allocentric neglect dyslexia. J Clin Exp Neuropsychol 2020; 42:352-362. [PMID: 32063093 PMCID: PMC7175469 DOI: 10.1080/13803395.2020.1715926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Consistently lateralized reading errors are commonly understood as side-effects of visuospatial neglect impairment. There is however a qualitative difference between systematically omitting full words presented on one side of passages (egocentric neglect dyslexia) and lateralized errors when reading single words (allocentric neglect dyslexia). This study aims to investigate the relationship between egocentric and allocentric neglect dyslexia and visuospatial neglect. 1209 stroke survivors completed standardized reading and cancellation tests. Stringent criteria identified unambiguous cases of allocentric neglect dyslexia (N = 17) and egocentric neglect dyslexia (N = 35). These conditions were found to be doubly dissociated with all cases of egocentric and allocentric neglect dyslexia occurring independently. Allocentric neglect dyslexia was dissociated from both egocentric and allocentric visuospatial neglect. Additionally, two cases of allocentric neglect dyslexia which co-occurred with oppositely lateralized domain-general visuospatial neglect were identified. Conversely, all cases of egocentric neglect dyslexia were found in the presence of domain-general visuospatial neglect. These findings suggest that allocentric neglect dyslexia cannot be fully understood as a consequence of visuospatial neglect. In contrast, we found no evidence for a dissociation between egocentric neglect dyslexia and visuospatial neglect. These findings highlight the need for new, neglect dyslexia specific rehabilitation strategies to be designed and tested.
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Affiliation(s)
- Margaret Jane Moore
- Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
| | - Nir Shalev
- Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
| | - Celine R Gillebert
- Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK.,Department of Brain and Cognition, KU Leuven, Leuven, Belgium
| | - Nele Demeyere
- Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
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22
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Neglect dyslexia as a word-centred impairment: A single case study. Cortex 2019; 119:543-554. [DOI: 10.1016/j.cortex.2018.10.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/30/2018] [Accepted: 10/28/2018] [Indexed: 12/18/2022]
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23
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Facchin A, Vallar G, Daini R. The Brentano Illusion Test (BRIT): An implicit task of perceptual processing for the assessment of visual field defects in neglect patients. Neuropsychol Rehabil 2019; 31:39-56. [PMID: 31438751 DOI: 10.1080/09602011.2019.1655067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In brain damaged patients with unilateral spatial neglect (USN), the differential diagnosis between the presence and absence of a unilateral visual half-field deficit (VHFD) is hampered by the similarity of their phenomenology. The absence of stimuli detection in the contralateral visual field, indeed, can be due to the co-occurrence of USN and VHFD or the sole presence of the USN. The disentangling of the two conditions is required to devise more specific rehabilitation programmes. Daini et al. [2002. Exploring the syndrome of spatial unilateral neglect through an illusion of length. Experimental Brain Research, 144(2), 224-237.] reported a difference in performance for the two conditions when the tasks required the bisection of Brentano illusory stimuli. Only when USN and VHFD co-occurred, the leftward illusory effect was disrupted. Based on previous findings, in this cross-sectional study, we developed the Brentano Illusion Test (BRIT), a clinical tool that helps the identification of VHFD in USN patients. The BRIT is a simple behavioural test of line bisection aimed at verifying the presence or absence of implicit processing in USN and thus helping the diagnosis of VHFD in USN patients; it also provides normative data for the line bisection task and the length effect.
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Affiliation(s)
- Alessio Facchin
- Department of Psychology, Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy.,University Research Centre in Optics and Optometry, University of Milano-Bicocca (COMiB), Milano, Italy.,Institute of Research and Studies in Optics and Optometry, Vinci, Italy
| | - Giuseppe Vallar
- Department of Psychology, Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy.,Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Roberta Daini
- Department of Psychology, Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy.,University Research Centre in Optics and Optometry, University of Milano-Bicocca (COMiB), Milano, Italy
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24
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Abstract
Unilateral spatial neglect is a disabling neurologic deficit, most frequent and severe after right-hemispheric lesions. In most patients neglect involves the left side of space, contralateral to a right-hemispheric lesion. About 50% of stroke patients exhibit neglect in the acute phase. Patients fail to orient, respond to, and report sensory events occurring in the contralateral sides of space and of the body, to explore these portions of space through movements by action effectors (eye, limbs), and to move the contralateral limbs. Neglect is a multicomponent higher-level disorder of spatial awareness, cognition, and attention. Spatial neglect may occur independently of elementary sensory and motor neurologic deficits, but it can mimic and make them more severe. Diagnostic tests include: motor exploratory target cancellation; setting the midpoint of a horizontal line (bisection), that requires the estimation of lateral extent; drawing by copy and from memory; reading, assessing neglect dyslexia; and exploring the side of the body contralateral to the lesion. Activities of daily living scales are also used. Patients are typically not aware of neglect, although they may exhibit varying degrees of awareness toward different components of the deficit. The neural correlates include lesions to the inferior parietal lobule of the posterior parietal cortex, which was long considered the unique neuropathologic correlate of neglect, to the premotor and to the dorsolateral prefrontal cortices, to the posterior superior temporal gyrus, at the temporoparietal junction, to subcortical gray nuclei (thalamus, basal ganglia), and to parietofrontal white-matter fiber tracts, such as the superior longitudinal fascicle. Damage to the inferior parietal lobule of the posterior parietal cortex is specifically associated with the mainly egocentric, perceptual, and exploratory extrapersonal, and with the personal, bodily components of neglect. Productive manifestations, such as perseveration, are not a correlate of posterior parietal cortex damage.
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25
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Abstract
Prism adaptation (PA) has been successfully applied in the rehabilitation of spatial neglect, with significant transfer to classic neglect tests and activities of daily living. However, well-controlled studies were unable to replicate these findings, and recent reports suggest that PA may affect selectively visuo-motor symptoms. Here, a patient with pure left neglect dyslexia was tested before, immediately after, and 24 h after PA. Despite a significant adaptation aftereffect adaptation had no effect omissions, substitutions and letter-based errors. PA does not affect pure neglect dyslexia and should therefore be reserved for the rehabilitation of motor-intentional, rather than visual-attentional symptoms.
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Affiliation(s)
- Radek Ptak
- a Division of Neurorehabilitation , Geneva University Hospitals , Geneva , Switzerland.,b Laboratory of Cognitive Neurorehabilitation, Faculty of Medicine , University of Geneva , Geneva , Switzerland.,c Cognitive Psychology, Faculty of Psychology and Educational Sciences , University of Geneva , Geneva , Switzerland
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26
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Siéroff E. Acquired spatial dyslexia. Ann Phys Rehabil Med 2017; 60:155-159. [DOI: 10.1016/j.rehab.2015.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 07/04/2015] [Indexed: 10/23/2022]
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27
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Ptak R, Di Pietro M, Pignat JM. The role of parieto-temporal connectivity in pure neglect dyslexia. Brain Res 2016; 1648:144-151. [DOI: 10.1016/j.brainres.2016.07.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 07/01/2016] [Accepted: 07/19/2016] [Indexed: 10/21/2022]
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28
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Ronchi R, Algeri L, Chiapella L, Gallucci M, Spada MS, Vallar G. Left neglect dyslexia: Perseveration and reading error types. Neuropsychologia 2016; 89:453-464. [DOI: 10.1016/j.neuropsychologia.2016.07.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 04/15/2016] [Accepted: 07/19/2016] [Indexed: 11/28/2022]
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29
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Chen P, Fyffe DC, Hreha K. Informal caregivers' burden and stress in caring for stroke survivors with spatial neglect: an exploratory mixed-method study. Top Stroke Rehabil 2016; 24:24-33. [PMID: 27216085 DOI: 10.1080/10749357.2016.1186373] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Spatial neglect prolongs stroke survivors' recovery to independence. However, little is known about the impact of spatial neglect on caregivers of stroke survivors. OBJECTIVE To explore the factors associated with burden and stress among informal caregivers of stroke survivors with spatial neglect. METHODS Following the previous study of 108 stroke survivors, we reached 24 stroke survivors' caregivers, and 20 caregivers (age: M±SD=56.9±12.7 years; 12 females) completed the study. 10 survivors had symptoms of spatial neglect, and 10 did not (i.e., SN+ or SN-, respectively) at the time when discharged from inpatient rehabilitation, which was 9.3±6.2 months before the present study. Via a semi-structured telephone interview, we assessed caregivers' burden and stress qualitatively and quantitatively. RESULTS No difference was observed across caregiver groups in cognitive function, depressive mood, or community mobility. In comparison, caregivers of the SN+ group allocated more time to care, controlling for survivors' disability (adjusted effective size d = 1.80). Their self-perceived burden and stress were more severe than the other group (adjusted d = .99). Qualitative analysis indicated caregivers of the SN+ group were more likely to describe economic stressors and undesirable changes in career and vacation planning. While 80% of participants preferred their care recipients to receive additional motor or mobility therapy, caregivers of the SN+ group were more likely to suggest additional therapy for cognitive impairment. CONCLUSIONS This exploratory study suggests that spatial neglect may heighten caregivers' burden and stress levels. Future studies with a large sample size are required.
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Affiliation(s)
- Peii Chen
- a Kessler Foundation , 1199 Pleasant Valley Way, West Orange, New Jersey , 07052 , USA.,b Department of Physical Medicine and Rehabilitation , Rutgers University , USA
| | - Denise C Fyffe
- a Kessler Foundation , 1199 Pleasant Valley Way, West Orange, New Jersey , 07052 , USA.,b Department of Physical Medicine and Rehabilitation , Rutgers University , USA
| | - Kimberly Hreha
- c Department of Biobehavioral Sciences , Teachers College, Columbia University , USA.,d Kessler Institute for Rehabilitation , USA
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Tarrasch R, Berman Z, Friedmann N. Mindful Reading: Mindfulness Meditation Helps Keep Readers with Dyslexia and ADHD on the Lexical Track. Front Psychol 2016; 7:578. [PMID: 27242565 PMCID: PMC4862243 DOI: 10.3389/fpsyg.2016.00578] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/07/2016] [Indexed: 12/03/2022] Open
Abstract
This study explored the effects of a Mindfulness-Based Stress Reduction (MBSR) intervention on reading, attention, and psychological well-being among people with developmental dyslexia and/or attention deficits. Various types of dyslexia exist, characterized by different error types. We examined a question that has not been tested so far: which types of errors (and dyslexias) are affected by MBSR training. To do so, we tested, using an extensive battery of reading tests, whether each participant had dyslexia, and which errors types s/he makes, and then compared the rate of each error type before and after the MBSR workshop. We used a similar approach to attention disorders: we evaluated the participants’ sustained, selective, executive, and orienting of attention to assess whether they had attention-disorders, and if so, which functions were impaired. We then evaluated the effect of MBSR on each of the attention functions. Psychological measures including mindfulness, stress, reflection and rumination, lifesatisfaction, depression, anxiety, and sleep-disturbances were also evaluated. Nineteen Hebrew-readers completed a 2-month mindfulness workshop. The results showed that whereas reading errors of letter-migrations within and between words and vowelletter errors did not decrease following the workshop, most participants made fewer reading errors in general following the workshop, with a significant reduction of 19% from their original number of errors. This decrease mainly resulted from a decrease in errors that occur due to reading via the sublexical rather than the lexical route. It seems, therefore, that mindfulness helped reading by keeping the readers on the lexical route. This improvement in reading probably resulted from improved sustained attention: the reduction in sublexical reading was significant for the dyslexic participants who also had attention deficits, and there were significant correlations between reduced reading errors and decreases in impulsivity. Following the meditation workshop, the rate of commission errors decreased, indicating decreased impulsivity, and the variation in RTs in the CPT task decreased, indicating improved sustained attention. Significant improvements were obtained in participants’ mindfulness, perceived-stress, rumination, depression, state-anxiety, and sleep-disturbances. Correlations were also obtained between reading improvement and increased mindfulness following the workshop. Thus, whereas mindfulness training did not affect specific types of errors and did not improve dyslexia, it did affect the reading of adults with developmental dyslexia and ADHD, by helping them to stay on the straight path of the lexical route while reading. Thus, the reading improvement induced by mindfulness sheds light on the intricate relation between attention and reading. Mindfulness reduced impulsivity and improved sustained attention, and this, in turn, improved reading of adults with developmental dyslexia and ADHD, by helping them to read via the straight path of the lexical route.
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Affiliation(s)
- Ricardo Tarrasch
- School of Education and Sagol School of Neuroscience, Tel Aviv University Tel Aviv, Israel
| | - Zohar Berman
- School of Psychology, Tel Aviv University Tel Aviv, Israel
| | - Naama Friedmann
- School of Education and Sagol School of Neuroscience, Tel Aviv University Tel Aviv, Israel
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Reznick J, Friedmann N. Evidence from neglect dyslexia for morphological decomposition at the early stages of orthographic-visual analysis. Front Hum Neurosci 2015; 9:497. [PMID: 26528159 PMCID: PMC4606021 DOI: 10.3389/fnhum.2015.00497] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 08/27/2015] [Indexed: 11/13/2022] Open
Abstract
This study examined whether and how the morphological structure of written words affects reading in word-based neglect dyslexia (neglexia), and what can be learned about morphological decomposition in reading from the effect of morphology on neglexia. The oral reading of 7 Hebrew-speaking participants with acquired neglexia at the word level-6 with left neglexia and 1 with right neglexia-was evaluated. The main finding was that the morphological role of the letters on the neglected side of the word affected neglect errors: When an affix appeared on the neglected side, it was neglected significantly more often than when the neglected side was part of the root; root letters on the neglected side were never omitted, whereas affixes were. Perceptual effects of length and final letter form were found for words with an affix on the neglected side, but not for words in which a root letter appeared in the neglected side. Semantic and lexical factors did not affect the participants' reading and error pattern, and neglect errors did not preserve the morpho-lexical characteristics of the target words. These findings indicate that an early morphological decomposition of words to their root and affixes occurs before access to the lexicon and to semantics, at the orthographic-visual analysis stage, and that the effects did not result from lexical feedback. The same effects of morphological structure on reading were manifested by the participants with left- and right-sided neglexia. Since neglexia is a deficit at the orthographic-visual analysis level, the effect of morphology on reading patterns in neglexia further supports that morphological decomposition occurs in the orthographic-visual analysis stage, prelexically, and that the search for the three letters of the root in Hebrew is a trigger for attention shift in neglexia.
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Affiliation(s)
- Julia Reznick
- Language and Brain Lab, Tel Aviv University Tel Aviv, Israel
| | - Naama Friedmann
- Language and Brain Lab, Tel Aviv University Tel Aviv, Israel
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Friedmann N, Gvion A, Nisim R. Insights from letter position dyslexia on morphological decomposition in reading. Front Hum Neurosci 2015; 9:143. [PMID: 26190985 PMCID: PMC4490734 DOI: 10.3389/fnhum.2015.00143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 03/02/2015] [Indexed: 11/13/2022] Open
Abstract
We explored morphological decomposition in reading, the locus in the reading process in which it takes place and its nature, comparing different types of morphemes. We assessed these questions through the analysis of letter position errors in readers with letter position dyslexia (LPD). LPD is a selective impairment to letter position encoding in the early stage of word reading, which results in letter migrations (such as reading "cloud" for "could"). We used the fact that migrations in LPD occur mainly in word-interior letters, whereas exterior letters rarely migrate. The rationale was that if morphological decomposition occurs prior to letter position encoding and strips off affixes, word-interior letters adjacent to an affix (e.g., signs-signs) would become exterior following affix-stripping and hence exhibit fewer migrations. We tested 11 Hebrew readers with developmental LPD and 1 with acquired LPD in 6 experiments of reading aloud, lexical decision, and comprehension, at the single word and sentence levels (compared with 25 age-matched control participants). The LPD participants read a total of 12,496 migratable words. We examined migrations next to inflectional, derivational, or bound function morphemes compared with migrations of exterior letters. The results were that root letters adjacent to inflectional and derivational morphemes were treated like middle letters, and migrated frequently, whereas root letters adjacent to bound function morphemes patterned with exterior letters, and almost never migrated. Given that LPD is a pre-lexical deficit, these results indicate that morphological decomposition takes place in an early, pre-lexical stage. The finding that morphologically complex nonwords showed the same patterns indicates that this decomposition is structurally, rather than lexically, driven. We suggest that letter position encoding takes place before morphological analysis, but in some cases, as with bound function morphemes, the complex word is re-analyzed as two separate words. In this reanalysis, letter positions in each constituent word are encoded separately, and hence the exterior letters of the root are treated as exterior and do not migrate.
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Affiliation(s)
- Naama Friedmann
- Language and Brain Lab, Tel Aviv University Tel Aviv, Israel
| | - Aviah Gvion
- Language and Brain Lab, Tel Aviv University Tel Aviv, Israel ; Reuth Medical and Rehabilitation Center Tel Aviv, Israel ; Communication Sciences and Disorders, Ono Academic College Tel Aviv, Israel
| | - Roni Nisim
- Language and Brain Lab, Tel Aviv University Tel Aviv, Israel
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Saj A, Barisnikov K. Influence of spatial perception abilities on reading in school-age children. COGENT PSYCHOLOGY 2015. [DOI: 10.1080/23311908.2015.1049736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Arnaud Saj
- Department of Neurology, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland
- Department of Neurosciences, Laboratory of Neurology and Imaging Cognition, University of Geneva, Geneva, Switzerland
| | - Koviljka Barisnikov
- Child Clinical Neuropsychology Unit, Department of Psychology, University of Geneva, Geneva, Switzerland
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Impact of spatial neglect on stroke rehabilitation: evidence from the setting of an inpatient rehabilitation facility. Arch Phys Med Rehabil 2015; 96:1458-66. [PMID: 25862254 DOI: 10.1016/j.apmr.2015.03.019] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 03/18/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine the impact of spatial neglect on rehabilitation outcome, risk of falls, and discharge disposition in stroke survivors. DESIGN Inception cohort. SETTING Inpatient rehabilitation facility (IRF). PARTICIPANTS Individuals with unilateral brain damage after their first stroke (N=108) were assessed at IRF admission and discharge. At admission, 74 of them (68.5%) demonstrated symptoms of spatial neglect as measured using the Kessler Foundation Neglect Assessment Process (KF-NAP). INTERVENTIONS Usual and standard IRF care. MAIN OUTCOME MEASURES The FIM, Conley Scale, number of falls, length of stay (LOS), and discharge disposition. RESULTS The greater the severity of spatial neglect (higher KF-NAP scores) at IRF admission and the lower the FIM scores at admission as well as at discharge. Higher KF-NAP scores also correlated with greater LOS and lower FIM improvement rate. The presence of spatial neglect (KF-NAP score>0), but not Conley Scale scores, predicted falls such that participants with spatial neglect fell 6.5 times more often than those without symptoms. More severe neglect, indicated by KF-NAP scores at IRF admission, reduced the likelihood of returning home at discharge. A model that took spatial neglect and other demographic, socioeconomic, and clinical factors into account predicted home discharge. Rapid FIM improvement during IRF stay and lower annual income level were significant predictors of home discharge. CONCLUSIONS Spatial neglect after a stroke is a prevalent problem and may negatively affect rehabilitation outcome, risk of falls, and LOS.
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Primativo S, Arduino LS, Daini R, De Luca M, Toneatto C, Martelli M. Impaired oculo-motor behaviour affects both reading and scene perception in neglect patients. Neuropsychologia 2015; 70:90-106. [PMID: 25698638 DOI: 10.1016/j.neuropsychologia.2015.02.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 02/11/2015] [Accepted: 02/16/2015] [Indexed: 10/24/2022]
Abstract
Unilateral spatial neglect (USN) is a common neuropsychological disorder following a right-sided brain lesion. Although USN is mostly characterized by symptoms involving the left hemispace, other symptoms are not left lateralized. Recently, it was shown that patients with neglect dyslexia, a reading disturbance that affects about 40% of USN patients, manifest a non-lateralized impairment of eye movement behaviour in association with their reading deficit when they read aloud and perform non-verbal saccadic tasks (Primativo et al., 2013). In the present paper, we aimed to demonstrate that the eye movement impairment shown by some USN patients reflects a more general oculo-motor disorder that is not confined to orthographic material, the horizontal axis or constrained saccadic tasks. We conjectured that inaccurate oculo-motor behaviour in USN patients indicates the presence of a reading deficit. With this aim we evaluated 20 patients, i.e., 10 right-sided brain-damaged patients without neglect and 10 patients affected by USN. On the basis of the patients' eye movement patterns during a scene exploration task, we found that 4 out of the 10 USN patients presented an abnormal oculo-motor pattern. These same four patients (but not the others) also failed in performing 5 different saccadic tasks and produced neglect dyslexia reading errors in both single words and texts. First, we show that a large proportion of USN patients have inaccurate eye movement behaviour in non-reading tasks. Second, we demonstrate that this exploratory deficit is predictive of the reading impairment. Thus, we conclude that the eye movement deficit prevents reading and impairs the performance on many other perceptual tests, including scene exploration. The large percentage of patients with impaired eye-movement pattern suggests that particular attention should be paid to eye movement behaviour during the diagnostic phase in order to program the best rehabilitation strategy for each patient.
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Affiliation(s)
- Silvia Primativo
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Psychology, Sapienza University of Rome, Rome, Italy; Dementia Research Centre, UCL Institute of Neurology, University College London, National Hospital, Queen Square, Box 16, London WC1N 3BG, UK.
| | | | - Roberta Daini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Maria De Luca
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Carlo Toneatto
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Marialuisa Martelli
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Psychology, Sapienza University of Rome, Rome, Italy.
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Lukov L, Friedmann N, Shalev L, Khentov-Kraus L, Shalev N, Lorber R, Guggenheim R. Dissociations between developmental dyslexias and attention deficits. Front Psychol 2015; 5:1501. [PMID: 25628578 PMCID: PMC4290487 DOI: 10.3389/fpsyg.2014.01501] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 10/13/2014] [Indexed: 11/13/2022] Open
Abstract
We examine whether attention deficits underlie developmental dyslexia, or certain types of dyslexia, by presenting double dissociations between the two. We took into account the existence of distinct types of dyslexia and of attention deficits, and focused on dyslexias that may be thought to have an attentional basis: letter position dyslexia (LPD), in which letters migrate within words, attentional dyslexia (AD), in which letters migrate between words, neglect dyslexia, in which letters on one side of the word are omitted or substituted, and surface dyslexia, in which words are read via the sublexical route. We tested 110 children and adults with developmental dyslexia and/or attention deficits, using extensive batteries of reading and attention. For each participant, the existence of dyslexia and the dyslexia type were tested using reading tests that included stimuli sensitive to the various dyslexia types. Attention deficit and its type was established through attention tasks assessing sustained, selective, orienting, and executive attention functioning. Using this procedure, we identified 55 participants who showed a double dissociation between reading and attention: 28 had dyslexia with normal attention and 27 had attention deficits with normal reading. Importantly, each dyslexia with suspected attentional basis dissociated from attention: we found 21 individuals with LPD, 13 AD, 2 neglect dyslexia, and 12 surface dyslexia without attention deficits. Other dyslexia types (vowel dyslexia, phonological dyslexia, visual dyslexia) also dissociated from attention deficits. Examination of 55 additional individuals with both a specific dyslexia and a certain attention deficit found no attention function that was consistently linked with any dyslexia type. Specifically, LPD and AD dissociated from selective attention, neglect dyslexia dissociated from orienting, and surface dyslexia dissociated from sustained and executive attention. These results indicate that visuospatial attention deficits do not underlie these dyslexias.
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Affiliation(s)
- Limor Lukov
- School of Education and Sagol School of Neuroscience, Tel Aviv University Tel Aviv, Israel
| | - Naama Friedmann
- School of Education and Sagol School of Neuroscience, Tel Aviv University Tel Aviv, Israel
| | - Lilach Shalev
- School of Education and Sagol School of Neuroscience, Tel Aviv University Tel Aviv, Israel
| | - Lilach Khentov-Kraus
- School of Education and Sagol School of Neuroscience, Tel Aviv University Tel Aviv, Israel
| | - Nir Shalev
- School of Education and Sagol School of Neuroscience, Tel Aviv University Tel Aviv, Israel
| | - Rakefet Lorber
- School of Education and Sagol School of Neuroscience, Tel Aviv University Tel Aviv, Israel
| | - Revital Guggenheim
- School of Education and Sagol School of Neuroscience, Tel Aviv University Tel Aviv, Israel
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Ronchi R, Bolognini N, Gallucci M, Chiapella L, Algeri L, Spada MS, Vallar G. (Un)awareness of unilateral spatial neglect: A quantitative evaluation of performance in visuo-spatial tasks. Cortex 2014; 61:167-82. [DOI: 10.1016/j.cortex.2014.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 06/06/2014] [Accepted: 10/06/2014] [Indexed: 11/25/2022]
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Galletta EE, Campanelli L, Maul KK, Barrett AM. Assessment of neglect dyslexia with functional reading materials. Top Stroke Rehabil 2014; 21:75-86. [PMID: 24521842 DOI: 10.1310/tsr2101-75] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Spatial neglect is a neurocognitive disorder that affects perception, representation, and/or motor planning. Neglect dyslexia in spatial neglect after right hemisphere damage may co-occur with, or be dissociated from, other spatial neglect signs. Previous neglect dyslexia research focused on word-level stimuli and reading errors. Using single words for assessment may leave some people with neglect dyslexia undiagnosed, and assessment materials that are closer to texts read in real life may better capture neglect dyslexia. METHOD The authors tested reading in 67 right hemisphere stroke survivors with 4 types of text materials: words, phrases, an article, and a menu. RESULTS Accuracy on reading the menu and article texts was significantly poorer than reading the words and phrases. The hypothesis that assessment materials with ecological validity such as reading a menu and reading an article may be more challenging than reading single words and phrases was supported. CONCLUSION Results suggest that neglect dyslexia assessment after stroke should include text materials comparable to those read in everyday life. Increasing the spatial extent of training materials in future research might also yield better functional generalization after right brain stroke.
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Affiliation(s)
- Elizabeth E Galletta
- Hunter College, The City University of New York, New York, New York The Graduate School and University Center, The City University of New York, New York, New York Kessler Foundation Research Center, West Orange, New Jersey
| | - Luca Campanelli
- The Graduate School and University Center, The City University of New York, New York, New York
| | - Kristen K Maul
- Kessler Foundation Research Center, West Orange, New Jersey
| | - A M Barrett
- Kessler Foundation Research Center, West Orange, New Jersey New Jersey Medical School, Newark, New Jersey
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Friedmann N, Gvion A. Compound reading in Hebrew text-based neglect dyslexia: the effects of the first word on the second word and of the second on the first. Cogn Neuropsychol 2014; 31:106-22. [PMID: 24617530 DOI: 10.1080/02643294.2014.884059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In many Hebrew compounds, which are two-word phrases, the first word is marked morphophonologically, and often also orthographically, as the head of the compound. Because Hebrew is read from right to left, this allowed us to ask whether a right-hand word that is marked orthographically as a compound-head, and hence signals that another word is expected, causes readers with text-based neglect to continue shifting attention to the left and read the second word. We also asked whether the second, left-hand, word affects the reading of the first word. The effect of the second word was assessed in a condition in which the second word semantically disambiguated the first word, a biased heterophonic homograph, and a condition in which the second word formed a compound with the first and hence required reading the first in the morphophonological form of a compound-head. The two participants were Hebrew-speaking men with acquired left text-level neglect dyslexia, without word-based neglect dyslexia. They read 294 two-word compounds and control phrases, composed of five conditions that assessed the effect of the first word on the second word, and of the second on the first. The results indicated that morphosyntax modulates reading in neglect dyslexia. When the first, right-hand, word included an orthographic cue indicating that a second word follows, fewer words on the left were omitted than when no such cue existed. The second word, however, did not affect the reading of the first, and the first word was read as if the patients did not look ahead to the second.
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Affiliation(s)
- Naama Friedmann
- a Language and Brain Lab, School of Education and Sagol School of Neuroscience , Tel Aviv University , Tel Aviv , Israel
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Beschin N, Cisari C, Cubelli R, Della Sala S. Prose Reading in Neglect. Brain Cogn 2014; 84:69-75. [DOI: 10.1016/j.bandc.2013.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 11/04/2013] [Accepted: 11/06/2013] [Indexed: 10/25/2022]
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Basagni B, Patané I, Ferrari V, Bruno N. Impaired reading not due to visual field loss in a patient with a right-hemipsheric lesion. Neurocase 2014; 20:510-23. [PMID: 23984952 DOI: 10.1080/13554794.2013.826684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We describe a right-handed patient (M.B.), who developed left hemianopsia and a severe reading impairment after right occipital-parietal hemorrhage. The pattern of his reading deficit was very similar to that of pure alexia (alexia-without-agraphia): extremely slow reading times with frequent grapheme substitutions and omissions. A test of letter reading while controlling for saccadic eye movements and hemifield of presentation ruled out hemianoptic alexia. Although there have already been reports of reading impairments in right handers following right- hemispheric lesions, ours is, to the best of our knowledge, the first where visual field loss can be definitely excluded as the main cause. Based on a standard neuropsychological assessment and on additional behavioral tests, we argue that M.B.'s difficulties are unlikely to be due to right-hemisphere dominance for language. After considering several candidate explanations, we suggest that M.B.'s symptoms may be related to an impairment in attentional processes related to reading.
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Affiliation(s)
- Benedetta Basagni
- a Centro S. Maria ai Servi, Fondazione Don Carlo Gnocchi , Parma , Italy
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Veronelli L, Vallar G, Marinelli CV, Primativo S, Arduino LS. Line and word bisection in right-brain-damaged patients with left spatial neglect. Exp Brain Res 2013; 232:133-46. [DOI: 10.1007/s00221-013-3726-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 09/27/2013] [Indexed: 11/28/2022]
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The two sides of spatial representation in neglect patients: The same spatial distortion for different patterns of performance. Neuropsychologia 2013; 51:1867-77. [DOI: 10.1016/j.neuropsychologia.2013.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 05/08/2013] [Accepted: 06/13/2013] [Indexed: 11/22/2022]
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Neglect dyslexia: a matter of "good looking". Neuropsychologia 2013; 51:2109-19. [PMID: 23850599 DOI: 10.1016/j.neuropsychologia.2013.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 06/27/2013] [Accepted: 07/01/2013] [Indexed: 11/23/2022]
Abstract
Brain-damaged patients with right-sided unilateral spatial neglect (USN) often make left-sided errors in reading single words or pseudowords (neglect dyslexia, ND). We propose that both left neglect and low fixation accuracy account for reading errors in neglect dyslexia. Eye movements were recorded in USN patients with (ND+) and without (ND-) neglect dyslexia and in a matched control group of right brain-damaged patients without neglect (USN-). Unlike ND- and controls, ND+ patients showed left lateralized omission errors and a distorted eye movement pattern in both a reading aloud task and a non-verbal saccadic task. During reading, the total number of fixations was larger in these patients independent of visual hemispace, and most fixations were inaccurate. Similarly, in the saccadic task only ND+ patients were unable to reach the moving dot. A third experiment addressed the nature of the left lateralization in reading error distribution by simulating neglect dyslexia in ND- patients. ND- and USN- patients had to perform a speeded reading-at-threshold task that did not allow for eye movements. When stimulus exploration was prevented, ND- patients, but not controls, produced a pattern of errors similar to that of ND+ with unlimited exposure time (e.g., left-sided errors). We conclude that neglect dyslexia reading errors may arise in USN patients as a consequence of an additional and independent deficit unrelated to the orthographic material. In particular, the presence of an altered oculo-motor pattern, preventing the automatic execution of the fine saccadic eye movements involved in reading, uncovers, in USN patients, the attentional bias also in reading single centrally presented words.
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Marelli M, Aggujaro S, Molteni F, Luzzatti C. Understanding the mental lexicon through neglect dyslexia: a study on compound noun reading. Neurocase 2013; 19:128-44. [PMID: 22519604 DOI: 10.1080/13554794.2011.654222] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The present study employs neglect dyslexia (ND) as an experimental model to study compound-word processing; in particular, it investigates whether compound constituents are hierarchically organized at mental level and addresses the possibility of whole-word representation. Seven Italian-speaking patients suffering from ND participated in a word naming task. Both left-headed (pescespada, swordfish) and right-headed (astronave, spaceship) Italian compound nouns were used as stimuli. Non-existent compounds, which were generated by substituting the leftmost constituent of a compound with an orthographically similar word (e.g., *pestespada, *plaguesword), were also employed. A significant headedness effect emerged in the group analysis: patients read left-headed compounds better than right-headed compounds. A significant lexicality effect was also found: the participants read real compounds better than their non-existent compound pairs. Moreover, logit mixed-effects analyses indicated a left-hand constituent frequency effect. Results are discussed in terms of hierarchical representation of compounds and direct access to compound lemma nodes.
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Affiliation(s)
- Marco Marelli
- Department of Psychology, University of Milano-Bicocca, Milano, Italy.
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Buiatti T, Skrap M, Shallice T. Left- and right-hemisphere forms of phonological alexia. Cogn Neuropsychol 2013; 29:531-49. [PMID: 23521052 DOI: 10.1080/02643294.2013.771773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We studied the ability of patients with lesions arising from operation for an anterior or posterior (left or right) brain tumour to read a set of words and pronounceable nonwords. In line with previous works, we observed that damage to the left posterior or left anterior cortex can give rise to phonological alexia, where the reading performance of nonwords is affected more than that of words. More surprisingly, similar effects were found in the right posterior group. However, there were significant differences in the error types, for both complex and positional errors, between phonological alexic patients in the three location groups. The findings present difficulties for the position held by theorists of the triangle model that phonological alexia arises from impairments in the language production system or in a general-purpose orthographic-phonological translation system. They also pose new questions about the possible role of the right posterior cortex in letter sequence representation.
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Affiliation(s)
- Tania Buiatti
- Cognitive Neuroscience Sector, SISSA, Trieste, Italy
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Reinhart S, Schaadt AK, Adams M, Leonhardt E, Kerkhoff G. The frequency and significance of the word length effect in neglect dyslexia. Neuropsychologia 2013; 51:1273-8. [PMID: 23528849 DOI: 10.1016/j.neuropsychologia.2013.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 01/12/2013] [Accepted: 03/13/2013] [Indexed: 10/27/2022]
Abstract
Neglect patients often omit or misread initial letters of single words, a phenomenon termed neglect dyslexia (ND). Omissions of whole words on the contralesional side of the page during paragraph reading are generally considered as egocentric or space-based errors, whereas misreading of the left part of a word can be viewed as a type of stimulus-centred or word-based, neglect-related error. The research of the last decades shed light on several effects of word features (such as written word frequency, grammatical class or concreteness) that modulate the severity of ND. Nevertheless, almost all studies about those modulating factors were case studies and some of them have not been replicated yet. Therefore, to date we do not know how relevant such effects of different word stimuli are for a population of ND patients. Knowing their incidence would improve our theoretical understanding of ND and promote the development of standardized ND assessments, which are lacking so far. In particular, case studies have shown that ND error frequency increases systematically with word length (word length effect, WLE) while other single case studies found contrary results. Hence, the existence of the WLE in ND is unsettled and its incidence and significance in stroke patients is unknown. To clarify this issue we evaluated the relation between word length and the extent (number) of neglected or substituted letters within single words in ND (neglect dyslexia extent, NDE) in a group of 19 consecutive ND patients with right hemisphere lesions. We found a clear WLE in 79% (15 of 19) of our ND patients, as indicated by significant correlations between word length and NDE. Concurrent visual field defects had no effect on the WLE in our sample, thus showing no influence of early visual cortical processing stages on the WLE in neglect dyslexia. In conclusion, our results suggest a clear relationship between word length and reading errors in ND and show that the WLE is a frequent phenomenon in ND.
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Affiliation(s)
- Stefan Reinhart
- Saarland University, Clinical Neuropsychology Unit and Outpatient Service, Building A1.3, D-66123 Saarbruecken, Germany.
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Line bisection error predicts the presence and severity of neglect dyslexia in paragraph reading. Neuropsychologia 2013; 51:1-7. [DOI: 10.1016/j.neuropsychologia.2012.10.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 10/08/2012] [Accepted: 10/30/2012] [Indexed: 11/17/2022]
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