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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: 2] [Impact Index Per Article: 2.0] [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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Zigiotto L, Amorosino G, Saviola F, Jovicich J, Annicchiarico L, Rozzanigo U, Olivetti E, Avesani P, Sarubbo S. Spontaneous unilateral spatial neglect recovery after brain tumour resection: A multimodal diffusion and rs-fMRI case report. J Neuropsychol 2024; 18 Suppl 1:91-114. [PMID: 37431064 DOI: 10.1111/jnp.12339] [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: 02/02/2023] [Accepted: 05/25/2023] [Indexed: 07/12/2023]
Abstract
Patients with unilateral spatial neglect (USN) are unable to explore or to report stimuli presented in the left personal and extra-personal space. USN is usually caused by lesion of the right parietal lobe: nowadays, it is also clear the key role of structural connections (the second and the third branch of the right Superior Longitudinal Fasciculus, respectively, SLF II and III) and functional networks (Dorsal and Ventral Attention Network, respectively, DAN and VAN) in USN. In this multimodal case report, we have merged those structural and functional information derived from a patient with a right parietal lobe tumour and USN before surgery. Functional, structural and neuropsychological data were also collected 6 months after surgery, when the USN was spontaneously recovered. Diffusion metrics and Functional Connectivity (FC) of the right SLF and DAN, before and after surgery, were compared with the same data of a patient with a tumour in a similar location, but without USN, and with a control sample. Results indicate an impairment in the right SLF III and a reduction of FC of the right DAN in patients with USN before surgery compared to controls; after surgery, when USN was recovered, patient's diffusion metrics and FC showed no differences compared to the controls. This single case and its multimodal approach reinforce the crucial role of the right SLF III and DAN in the development and recovery of egocentric and allocentric extra-personal USN, highlighting the need to preserve these structural and functional areas during brain surgery.
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Affiliation(s)
- Luca Zigiotto
- Department of Neurosurgery, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Structural and Functional Connectivity Lab Project, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Department of Psychology, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Gabriele Amorosino
- Neuroinformatics Laboratory (NILab), Bruno Kessler Foundation (FBK), Trento, Italy
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Francesca Saviola
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Jorge Jovicich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Luciano Annicchiarico
- Department of Neurosurgery, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Structural and Functional Connectivity Lab Project, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Umberto Rozzanigo
- Department of Neuroradiology, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Emanuele Olivetti
- Neuroinformatics Laboratory (NILab), Bruno Kessler Foundation (FBK), Trento, Italy
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Paolo Avesani
- Neuroinformatics Laboratory (NILab), Bruno Kessler Foundation (FBK), Trento, Italy
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Silvio Sarubbo
- Department of Neurosurgery, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Structural and Functional Connectivity Lab Project, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
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Cova I, Mele F, Nicotra A, Maestri G, Cucumo V, Pomati S, Salvadori E, Pantoni L. The Luigi Sacco Hospital VAS-COG stroke care pathway: A five-year experience. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2024; 6:100210. [PMID: 38357360 PMCID: PMC10865214 DOI: 10.1016/j.cccb.2024.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/16/2024]
Abstract
Background Psycho-cognitive consequences are a frequent cause of disability in stroke survivors but are often underdiagnosed also because of lack of services dedicated to these aspects. We started assessing systematically cognitive and behavioral functions in acute stroke patients and to follow them up. Here, we report a retrospective analysis of the organization of the Sacco VAS-COG stroke care pathway and the refinements implemented during 5 years of activity. Methods The protocol includes baseline collection of clinical history, general and neurologic examinations, functional, neuropsychological, and neuroimaging assessment. At follow-up, a diagnosis of cognitive decline was made based on best clinical judgment in the first period (January 2018 to May 2019, namely VAS-COG protocol 1.0) and then based on an extensive neuropsychological battery (May 2019 to January 2023, namely VASCOG protocol 2.0); psychiatric and behavioral disturbances are investigated through suitable scales. Results From January 2018 to December 2022, 834 patients (mean age 76±13.6 years; 46.6 % females) with acute cerebrovascular events were admitted to the stroke unit, mostly (80 %) for ischemic strokes. Pre-event cognitive impairment was not assessable in 78 patients (9.3 %) because no reliable informant was present and was reported in 327/756 (43 %) patients. During follow-up, post-stroke cognitive impairment was detected in 124/217 (57.1 %) patients in VAS-COG protocol 1.0 and in 137/201(68.2 %) patients in VAS-COG protocol 2.0, while 95/218 (43.2 %) patients were found to be depressed and patients presented on average 2.5 neuropsychiatric symptoms on Neuropsychiatric Inventory-questionnaire. Conclusions The VAS-COG stroke care pathway represents a model for patients and for their families.
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Affiliation(s)
- I. Cova
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - F. Mele
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - A. Nicotra
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - G. Maestri
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - V. Cucumo
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - S. Pomati
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - E. Salvadori
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences, University of Milan, Via Giovanni Battista Grassi 7, Milano 20157, Italy
| | - L. Pantoni
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences, University of Milan, Via Giovanni Battista Grassi 7, Milano 20157, Italy
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De Ieso S, Di Rauso G, Cavallieri F, Beltrami D, Marti A, Napoli M, Pascarella R, Feletti A, Fioravanti V, Toschi G, Rispoli V, Antonelli F, Puzzolante A, Pavesi G, Gasparini F, Valzania F. Longitudinal Neuropsychological Assessment of Symptomatic Edema after Subthalamic Nucleus Deep Brain Stimulation Surgery: A Case Series Study. Neurol Int 2023; 16:62-73. [PMID: 38251052 PMCID: PMC10801618 DOI: 10.3390/neurolint16010004] [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: 08/29/2023] [Revised: 11/13/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Severe non-infectious or non-haemorrhagic brain edema surrounding the electrode represents a rare complication of subthalamic nucleus deep brain stimulation (STN-DBS) surgery. The aim of this study is to report three patients with advanced Parkinson's Disease (PD) who developed symptomatic brain edema after STN-DBS surgery treated with intravenous steroids with a specific profile of reversible cognitive alterations. Patients were both assessed with a comprehensive neuropsychological battery including attention, memory, visuo-spatial and executive tasks. They were also briefly assessed for emotional and behavioural alterations, and for possible limitations in the activities of daily living. Normative data for an Italian population were available for all neuropsychological tests. The patients were firstly assessed before the surgery (baseline) as soon as they became symptomatic for the post-surgery edema and a few more times in follow-up up to ten months. In all patients we observed the resolution of cognitive deficits within six months after surgery with the corresponding reabsorption of edema at brain CT scans. The appearance of post-DBS edema is a fairly frequent and clinically benign event. However, in some rare cases it can be very marked and lead to important clinical-albeit transient-disturbances. These events can compromise, at least from a psychological point of view, the delicate path of patients who undergo DBS and can prolong the post-operative hospital stay. In this setting it could be helpful to perform a brain CT scan in 2-3 days with the aim of detecting the early appearance of edema and treating it before it can constitute a relevant clinical problem.
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Affiliation(s)
- Silvia De Ieso
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.D.I.); (G.D.R.); (D.B.); (A.M.); (V.F.); (G.T.); (F.G.); (F.V.)
- Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Giulia Di Rauso
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.D.I.); (G.D.R.); (D.B.); (A.M.); (V.F.); (G.T.); (F.G.); (F.V.)
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41126 Modena, Italy
| | - Francesco Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.D.I.); (G.D.R.); (D.B.); (A.M.); (V.F.); (G.T.); (F.G.); (F.V.)
| | - Daniela Beltrami
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.D.I.); (G.D.R.); (D.B.); (A.M.); (V.F.); (G.T.); (F.G.); (F.V.)
- Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Alessandro Marti
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.D.I.); (G.D.R.); (D.B.); (A.M.); (V.F.); (G.T.); (F.G.); (F.V.)
- Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Manuela Napoli
- Neuroradiology Unit, Radiology Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.N.); (R.P.)
| | - Rosario Pascarella
- Neuroradiology Unit, Radiology Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.N.); (R.P.)
| | - Alberto Feletti
- Neurosurgery Unit, Ospedale Civile Baggiovara (OCB) Hospital, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy; (A.F.); (A.P.); (G.P.)
- Neurosurgery Unit, Azienda Ospedaliera Universitaria Integrata Verona, 37126 Verona, Italy
| | - Valentina Fioravanti
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.D.I.); (G.D.R.); (D.B.); (A.M.); (V.F.); (G.T.); (F.G.); (F.V.)
| | - Giulia Toschi
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.D.I.); (G.D.R.); (D.B.); (A.M.); (V.F.); (G.T.); (F.G.); (F.V.)
| | - Vittorio Rispoli
- Neurology Unit, Neuroscience Head Neck Department, Ospedale Civile Baggiovara (OCB) Hospital, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, Italy; (V.R.); (F.A.)
| | - Francesca Antonelli
- Neurology Unit, Neuroscience Head Neck Department, Ospedale Civile Baggiovara (OCB) Hospital, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, Italy; (V.R.); (F.A.)
| | - Annette Puzzolante
- Neurosurgery Unit, Ospedale Civile Baggiovara (OCB) Hospital, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy; (A.F.); (A.P.); (G.P.)
| | - Giacomo Pavesi
- Neurosurgery Unit, Ospedale Civile Baggiovara (OCB) Hospital, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy; (A.F.); (A.P.); (G.P.)
- Neurosurgery Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Federico Gasparini
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.D.I.); (G.D.R.); (D.B.); (A.M.); (V.F.); (G.T.); (F.G.); (F.V.)
- Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Franco Valzania
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.D.I.); (G.D.R.); (D.B.); (A.M.); (V.F.); (G.T.); (F.G.); (F.V.)
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Beccherle M, Gobbetto V, Bertagnoli S, Bulgarelli C, Rossato E, Moro V. Illusory hand movements in the absence of asomatognosia, spatial neglect and anosognosia for hemiplegia. Cortex 2023; 168:176-180. [PMID: 37741133 DOI: 10.1016/j.cortex.2023.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/25/2023]
Affiliation(s)
| | | | - Sara Bertagnoli
- Social and Cognitive Neuroscience Laboratory, Department of Psychology, University La Sapienza, Roma, Italy
| | | | - Elena Rossato
- IRCSS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Valentina Moro
- Npsy-Lab.Vr, Department of Human Sciences, University of Verona, Italy.
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Gerosa M, Peviani V, Salvato G, Pasotti F, Crivelli D, Bottini G. The nature of the task stimuli affects graphic perseveration severity: Insights from a single case study. Cortex 2023; 167:273-282. [PMID: 37582326 DOI: 10.1016/j.cortex.2023.06.017] [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: 02/16/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVE Graphic perseveration in target-cancellation tasks has been frequently described in patients with right brain damage and unilateral spatial neglect. Conversely, among patients with dementia, the spontaneous production of complex graphic perseverations, as well as their triggers and modulating factors, have been poorly understood. Here we describe the case of RM, a patient with Alzheimer's dementia, who produced a rich pattern of complex graphic perseverations at target-cancellation tasks, especially with abstract target stimuli, i.e., lines. METHOD We developed an ad-hoc behavioral paradigm to investigate patient RM's performance at two versions of a target-cancellation task: fork-cancellation and line-cancellation. In both versions, RM was asked to cross the blue targets, while crossing a red target was considered a false alarm, as a proxy of incorrect response inhibition capacity. Moreover, we classified the presence and intensity of two other graphic perseverative behaviors, i.e., additional marks and scribble perseveration. RESULTS Complex graphic perseverations and false alarms were more frequent in the line-compared to the fork-cancellation trials. Conversely, the semantic nature of the task did not differentially modulate the occurrence of additional marks and scribble perseverations. CONCLUSIONS We argue that the breakdown of RM's executive functioning at the semantic-representational level was a prerequisite for such complex graphic perseverations to occur. Furthermore, we provide hints on the potential modulatory effects of stimulus concreteness on the expression of such complex productive behavior.
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Affiliation(s)
- Marta Gerosa
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Cognitive Neuropsychology Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Valeria Peviani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Gerardo Salvato
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Cognitive Neuropsychology Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; NeuroMI, Milan Center for Neuroscience, Milan, Italy
| | - Fabrizio Pasotti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Department of Rehabilitation ASST Pavia, Voghera, Pavia, Italy
| | - Damiano Crivelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; NeuroMI, Milan Center for Neuroscience, Milan, Italy
| | - Gabriella Bottini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Cognitive Neuropsychology Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; NeuroMI, Milan Center for Neuroscience, Milan, Italy.
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Cantarella G, Vianello G, Vezzadini G, Frassinetti F, Ciaramelli E, Candini M. Time bisection and reproduction: Evidence for a slowdown of the internal clock in right brain damaged patients. Cortex 2023; 167:303-317. [PMID: 37595392 DOI: 10.1016/j.cortex.2023.05.024] [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: 10/06/2022] [Revised: 03/31/2023] [Accepted: 05/24/2023] [Indexed: 08/20/2023]
Abstract
Previous studies show that the right hemisphere is involved in time processing, and that damage to the right hemisphere is associated with a tendency to perceive time intervals as shorter than they are, and to reproduce time intervals as longer than they are. Whether time processing deficits following right hemisphere damage are related and what is their neurocognitive basis is unclear. In this study, right brain damaged (RBD) patients, left brain damaged (LBD) patients, and healthy controls underwent a time bisection task and a time reproduction task involving time intervals varying between each other by milliseconds (short durations) or seconds (long durations). The results show that in the time bisection task RBD patients underestimated time intervals compared to LBD patients and healthy controls, while they reproduced time intervals as longer than they are. Time underestimation and over-reproduction in RBD patients applied to short but not long time intervals, and were correlated. Voxel-based lesion-symptom mapping (VLSM) showed that time underestimation was associated with lesions to a right cortico-subcortical network involving the insula and inferior frontal gyrus. A small portion of this network was also associated with time over-reproduction. Our findings are consistent with a slowdown of an 'internal clock' timing mechanism following right brain damage, which likely underlies both the underestimation and the over-reproduction of time intervals, and their (overlapping) neural bases.
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Affiliation(s)
- Giovanni Cantarella
- Department of Psychology 'Renzo Canestrari', University of Bologna, Bologna, Italy; Center for Studies and Research of Cognitive Neuroscience, University of Bologna, Cesena, Italy
| | - Greta Vianello
- Istituti Clinici Scientifici Maugeri IRCCS, Castel Goffredo, Italy
| | | | - Francesca Frassinetti
- Department of Psychology 'Renzo Canestrari', University of Bologna, Bologna, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Castel Goffredo, Italy
| | - Elisa Ciaramelli
- Department of Psychology 'Renzo Canestrari', University of Bologna, Bologna, Italy; Center for Studies and Research of Cognitive Neuroscience, University of Bologna, Cesena, Italy.
| | - Michela Candini
- Department of Psychology 'Renzo Canestrari', University of Bologna, Bologna, Italy.
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Jang WH, Jang JS. Standardization of apple cancellation test for neglect patients in Korea: An observational study. World J Clin Cases 2023; 11:5236-5243. [PMID: 37621587 PMCID: PMC10445065 DOI: 10.12998/wjcc.v11.i22.5236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/08/2023] [Accepted: 07/11/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Neglect can be divided into two types using apple cancellation test (apple test): Egocentric neglect (EN) and allocentric neglect (AN). However, in South Korea, apple test results and decision criteria are still largely dependent on tests by foreign countries. AIM To establish a new South Korea standard and improve the accuracy of neglect assessment, the apple experiment was standardized in this study. METHODS This study was conducted on 223 healthy subjects for a total of 7 mo from August 2021 to February 2022. Standardization was carried out using the original apple test developed by Bickerton in 2011. In scoring for the apple test, total omission error refers to the number of missed targets (full apple) in the entire test sheet (left, middle, and right area). The score for EN is the difference between the cor-rect number of right area and the correct number of left area (excluding the middle area). For AN, the score is difference between the number of left opening apples and number of right opening apples (including the middle area). Linear regression analysis was used for standardization using the general characteristics of subjects and the results of the apple test. RESULTS The cut-off score, which is the standard value indicating the pathological condition by combining the results of all subjects, is as follows: Total omission error (5), error for EN (2), and error for AN (2). Also, differences in cut-off score according to age were found. CONCLUSION This study will be helpful in facilitating a more accurate differential diagnosis of neglect.
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Affiliation(s)
- Woo-Hyuk Jang
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Samcheok-si 25949, Gangwon-do, South Korea
| | - Jong-Sik Jang
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Samcheok-si 25949, Gangwon-do, South Korea
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Jang WH, Jang JS. Standardization of apple cancellation test for neglect patients in Korea: An observational study. World J Clin Cases 2023; 11:5230-5237. [DOI: 10.12998/wjcc.v11.i22.5230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/08/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Neglect can be divided into two types using apple cancellation test (apple test): Egocentric neglect (EN) and allocentric neglect (AN). However, in South Korea, apple test results and decision criteria are still largely dependent on tests by foreign countries.
AIM To establish a new South Korea standard and improve the accuracy of neglect assessment, the apple experiment was standardized in this study.
METHODS This study was conducted on 223 healthy subjects for a total of 7 mo from August 2021 to February 2022. Standardization was carried out using the original apple test developed by Bickerton in 2011. In scoring for the apple test, total omission error refers to the number of missed targets (full apple) in the entire test sheet (left, middle, and right area). The score for EN is the difference between the cor-rect number of right area and the correct number of left area (excluding the middle area). For AN, the score is difference between the number of left opening apples and number of right opening apples (including the middle area). Linear regression analysis was used for standardization using the general characteristics of subjects and the results of the apple test.
RESULTS The cut-off score, which is the standard value indicating the pathological condition by combining the results of all subjects, is as follows: Total omission error (5), error for EN (2), and error for AN (2). Also, differences in cut-off score according to age were found.
CONCLUSION This study will be helpful in facilitating a more accurate differential diagnosis of neglect.
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Affiliation(s)
- Woo-Hyuk Jang
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Samcheok-si 25949, Gangwon-do, South Korea
| | - Jong-Sik Jang
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Samcheok-si 25949, Gangwon-do, South Korea
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10
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Jang WH, Hwang HM, Kim JY. Effects of Twins Therapy on Egocentric and Allocentric Neglect in Stroke Patients: A Feasibility Study. Brain Sci 2023; 13:952. [PMID: 37371430 DOI: 10.3390/brainsci13060952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/06/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: Existing treatment methods for neglect are concentrated on egocentric neglect and may lead to various problems such as cost/space constraints and portability. Therefore, this study seeks to determine how a new treatment (also known as twins therapy, TT) for stroke patients can improve an existing problem associated with neglect. (2) Method: A pre/post-test control group research design was used and both groups continued to receive existing rehabilitation treatment, whilst TT intervention was only added to the experimental group. TT intervention was conducted for a total of 20 sessions (1 session for 30 min/day, 5 days/week, for 4 weeks). (3) Result: There was no significant difference in the manual function test (MFT) and the Korean version of the Modified Barthel Index (K-MBI) items (p > 0.05) before and after the TT intervention. However, the score and execution time of the apple cancellation test showed a significant reduction only in the experimental group (p < 0.05). (4) Conclusion: TT not only improved egocentric neglect, but also allocentric neglect symptoms in stroke patients.
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Affiliation(s)
- Woo-Hyuk Jang
- Department of Occupational Therapy, Kangwon National University, Samcheok 25949, Republic of Korea
| | - Hyeong-Min Hwang
- Department of Occupational Therapy, Kangwon National University, Samcheok 25949, Republic of Korea
| | - Jae-Yeop Kim
- Department of Occupational Therapy, Kangwon National University, Samcheok 25949, Republic of Korea
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11
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De Luca M, Baroncini M, Matano A, Di Lorenzo C, Magnotti L, Lucatello S, Mulas M, Pollarini V, Ciurli MP, Nardo D. Sensitivity and Specificity of the Brentano Illusion Test in the Detection of Visual Hemi-Field Deficits in Patients with Unilateral Spatial Neglect. Brain Sci 2023; 13:937. [PMID: 37371415 DOI: 10.3390/brainsci13060937] [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: 04/28/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Stroke survivors with right-brain damage (RBD) often present with attentional deficits such as left unilateral spatial neglect. Some patients also present with contralesional visual hemi-field deficits. A late detection of visual hemi-field deficits (VHFD) contributes to hampering neurorehabilitation and functional outcome of patients with neglect. The Brentano Illusion Test (BRIT) may be used for an early detection of VHFD during the neuropsychological assessment. In the present study, we determined the sensitivity and specificity of the BRIT for screening VHFD in patients with neglect. Sixty-four consecutive RBD patients were examined. Forty-five presented with neglect. Of these, 23 presented with VHFD (hemianopia or quadrantanopia) as detected by the Humphrey automated static visual field testing (reference standard). Consecutive patients also included 19 participants without neglect, who did not have any VHFD. The sensitivity and specificity of the BRIT for neglect patients were 78.3% (95% CI: 61.4-95.1) and 90.9 (95% CI: 78.9-100.0), respectively. Positive predictive value (PPV) was 89.6% (95% CI: 76.4-100.0); negative predictive value (NPV) 80.7% (95% CI: 65.2-96.2). No false positives in the group without neglect were identified. We conclude that the BRIT is an effective tool for clinical neuropsychologists to screen for possible VHFD in neglect patients during the neuropsychological assessment, allowing the refinement of the clinical picture in the neuropsychological report. An early detection of VHFD also allows referring the patient to standard diagnostics for a formal visual field examination, right from the first neuropsychological assessment.
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Affiliation(s)
| | | | | | | | | | | | - Martina Mulas
- Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Virginia Pollarini
- Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Davide Nardo
- Department of Education, University of Roma Tre, 00185 Rome, Italy
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12
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Massetti G, Albini F, Casati C, Toneatto C, Terruzzi S, Etzi R, Tesio L, Gallace A, Vallar G. Validation of "Neurit.Space": Three Digital Tests for the Neuropsychological Evaluation of Unilateral Spatial Neglect. J Clin Med 2023; 12:jcm12083042. [PMID: 37109378 PMCID: PMC10143133 DOI: 10.3390/jcm12083042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Patients suffering from Unilateral Spatial Neglect (USN) fail to pay attention to, respond to, and report sensory events occurring in the contralesional side of space. The traditional neuropsychological assessment of USN is based on paper-and-pencil tests, whose data recording and scoring may be subjected to human error. The utilization of technological devices can be expected to improve the assessment of USN. Therefore, we built Neurit.Space, a modified digital version of three paper-and-pencil tests, widely used to detect signs of USN, namely: Bells Cancellation, Line Bisection and Five Elements Drawing Test. Administration and data processing is fully automatic. Twelve right brain-damaged patients (six with and six without USN) and 12 age- and education-balanced healthy participants were enrolled in the study. All participants were administered both the computerized and the paper-and-pencil versions of the tests. The results of this preliminary study showed good sensitivity, specificity, and usability of Neurit.Space, suggesting that these digital tests are a promising tool for the evaluation of USN, both in clinical and in research settings.
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Affiliation(s)
- Gemma Massetti
- Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
- NeuroMI-Milan Center for Neuroscience, University of Milano-Bicocca, 20126 Milan, Italy
- MiBTec-Mind and Behavior Technological Center, University of Milano-Bicocca, 20126 Milan, Italy
- Specialistic Rehabilitation Unit, Neuropsychological Service, Casa di Cura Villa Barbarano, 25128 Brescia, Italy
| | - Federica Albini
- NeuroMI-Milan Center for Neuroscience, University of Milano-Bicocca, 20126 Milan, Italy
- MiBTec-Mind and Behavior Technological Center, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
- Neuropsychological Service, Department of Neurology, Desio Hospital, ASST Brianza, 20900 Monza, Italy
| | - Carlotta Casati
- Neuropsychological Laboratory, Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, 20122 Milan, Italy
| | - Carlo Toneatto
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Stefano Terruzzi
- MiBTec-Mind and Behavior Technological Center, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Roberta Etzi
- NeuroMI-Milan Center for Neuroscience, University of Milano-Bicocca, 20126 Milan, Italy
- MiBTec-Mind and Behavior Technological Center, University of Milano-Bicocca, 20126 Milan, Italy
| | - Luigi Tesio
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, 20122 Milan, Italy
- Department of Biomedical Sciences for Healthy, University of Milan, 20122 Milan, Italy
| | - Alberto Gallace
- NeuroMI-Milan Center for Neuroscience, University of Milano-Bicocca, 20126 Milan, Italy
- MiBTec-Mind and Behavior Technological Center, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Giuseppe Vallar
- NeuroMI-Milan Center for Neuroscience, University of Milano-Bicocca, 20126 Milan, Italy
- MiBTec-Mind and Behavior Technological Center, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
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13
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Lee SH, Lim BC, Jeong CY, Kim JH, Jang WH. Assessment tools for differential diagnosis of neglect: Focusing on egocentric neglect and allocentric neglect. World J Clin Cases 2022; 10:8625-8633. [PMID: 36157805 PMCID: PMC9453377 DOI: 10.12998/wjcc.v10.i24.8625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/09/2022] [Accepted: 07/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND There are very few studies on the differential diagnosis between egocentric neglect (EN) and allocentric neglect (AN).
AIM To investigate the overall trend of the previously developed assessment tools by conducting a descriptive review of the studies on assessment tools that can perform a differential diagnosis of EN and AN.
METHODS The data were collected by using databases such as Google Scholar, PubMed, and ScienceDirect. The most commonly used search terms were “neglect”, “stroke”, “egocentric neglect”, and “allocentric neglect”.
RESULTS A total of seven studies that met the inclusion criteria were selected and analyzed. We were able to confirm the research process, test method, and differential diagnosis criteria of the seven presented assessment tools from four studies on paper-based tests and three studies on computerized tests. The majority of the tests were carried out via the cancellation method using stimuli such as everyday objects or numbers. EN distinguished the left from right based on the test paper, while AN distinguished the left from right based on stimuli. In order to perform differential diagnosis, the difference in the number of left and right responses or non-responses was used based on the EN and AN criteria.
CONCLUSION It was confirmed that all the seven assessment tools can effectively perform differential diagnosis of EN and AN. This study may provide important data that can be used in clinical practice for differential diagnosis and future intervention planning for neglect patients.
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Affiliation(s)
- Sang-Hyeok Lee
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Gangwon-do 25949, South Korea
| | - Byeong-Chan Lim
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Gangwon-do 25949, South Korea
| | - Chan-Young Jeong
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Gangwon-do 25949, South Korea
| | - Jun-Hyeok Kim
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Gangwon-do 25949, South Korea
| | - Woo-Hyuk Jang
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Gangwon-do 25949, South Korea
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Aiello EN, Preti AN, Pucci V, Diana L, Corvaglia A, Barattieri di San Pietro C, Difonzo T, Zago S, Appollonio I, Mondini S, Bolognini N. The Italian telephone-based Verbal Fluency Battery (t-VFB): standardization and preliminary clinical usability evidence. Front Psychol 2022; 13:963164. [PMID: 35992426 PMCID: PMC9384842 DOI: 10.3389/fpsyg.2022.963164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background This study aimed at standardizing and providing preliminary evidence on the clinical usability of the Italian telephone-based Verbal Fluency Battery (t-VFB), which includes phonemic (t-PVF), semantic (t-SVF) and alternate (t-AVF) verbal fluency tasks. Methods Three-hundred and thirty-five Italian healthy participants (HPs; 140 males; age range = 18-96 years; education range = 4-23 years) and 27 individuals with neurodegenerative or cerebrovascular diseases were administered the t-VFB. Switch number and cluster size were computed via latent semantic analyses. HPs underwent the telephone-based Mental State Examination (MMSE) and Backward Digit Span (BDS). Construct validity, factorial structure, internal consistency, test-retest and inter-rater reliability and equivalence with the in-person Verbal Fluency tasks were assessed. Norms were derived via Equivalent Scores. Diagnostic accuracy against clinical populations was assessed. Results The majority of t-VFB scores correlated among each other and with the BDS, but not with the MMSE. Switch number correlated with t-PVF, t-SVF, t-AVF scores, whilst cluster size with the t-SVF and t-AVF scores only. The t-VFB was underpinned by a mono-component structure and was internally consistent (Cronbach's α = 0.91). Test-retest (ICC = 0.69-0.95) and inter-rater reliability (ICC = 0.98-1) were optimal. Each t-VFB test was statistically equivalent to its in-person version (equivalence bounds yielding a p < 0.05). Education predicted all t-VFB scores, whereas age t-SVF and t-AVF scores and sex only some t-SVF scores. Diagnostic accuracy against clinical samples was optimal (AUC = 0.81-0.86). Discussion The t-VFB is a valid, reliable and normed telephone-based assessment tool for language and executive functioning, equivalent to the in-person version; results show promising evidence of its diagnostic accuracy in neurological populations.
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Affiliation(s)
- Edoardo Nicolò Aiello
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Alice Naomi Preti
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Veronica Pucci
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova, Padua, Italy
- Human Inspired Technology Research Centre, University of Padova, Padua, Italy
| | - Lorenzo Diana
- Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Alessia Corvaglia
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Chiara Barattieri di San Pietro
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Teresa Difonzo
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Stefano Zago
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Ildebrando Appollonio
- Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Sara Mondini
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova, Padua, Italy
- Human Inspired Technology Research Centre, University of Padova, Padua, Italy
| | - Nadia Bolognini
- Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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15
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Prediction of post-stroke cognitive impairment by Montreal Cognitive Assessment (MoCA) performances in acute stroke: comparison of three normative datasets. Aging Clin Exp Res 2022; 34:1855-1863. [PMID: 35441928 PMCID: PMC9283135 DOI: 10.1007/s40520-022-02133-9] [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: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 11/30/2022]
Abstract
Background Cognitive assessment in acute stroke is relevant for identifying patients at risk of persistent post-stroke cognitive impairment (PSCI). Despite preliminary evidence on MoCA accuracy, there is no consensus on its optimal score in the acute stroke setting to predict PSCI. Aims (1) To explore whether the application of different normative datasets to MoCA scores obtained in the acute stroke setting results in variable frequency of patients defined as cognitively impaired; (2) to assess whether the normality cut-offs provided by three normative datasets predict PSCI at 6–9 months; (3) to calculate alternative MoCA cut-offs able to predict PSCI. Methods Consecutive stroke patients were reassessed at 6–9 months with extensive neuropsychological and functional batteries for PSCI determination. Results Out of 207 enrolled patients, 118 (57%) were followed-up (mean 7.4 ± 1.7 months), and 77 of them (65%) received a PSCI diagnosis. The application of the normality thresholds provided by the 3 normative datasets yielded to variable (from 28.5% to 41%) rates of patients having an impaired MoCA performance, and to an inadequate accuracy in predicting PSCI, maximizing specificity instead of sensitivity. In ROC analyses, a MoCA score of 22.82, adjusted according to the most recent normative dataset, achieved a good diagnostic accuracy in predicting PSCI. Conclusions The classification of acute stroke patients as normal/impaired based on MoCA thresholds proposed by general population normative datasets underestimated patients at risk of persistent PSCI. We calculated a new adjusted MoCA score predictive of PSCI in acute stroke patients to be further tested in larger studies.
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16
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Xie Y, Wang H, Chen Y, Liu F, Yao M, Zhang L, Liu P, Hong Q, Chi X, Yu D. Establishing Normative Data for the Number Cancelation Test Among Children in Kindergartens and Primary Schools in China. Front Psychiatry 2022; 13:788825. [PMID: 35479487 PMCID: PMC9035546 DOI: 10.3389/fpsyt.2022.788825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 02/25/2022] [Indexed: 11/30/2022] Open
Abstract
This study aimed to suggest an attention assessment tool using a Digital Pen for measuring the temporal-spatial parameters during the Number Cancelation Test (NCT), and then to establish the normative data for the NCT among children in kindergartens and primary schools in China by recruiting a total of 989 children (496 males). Four measures, i.e., selective attention (SA), speed of cognitive processing (SpC), averaged time of circlings (ATC), and averaged circumference of circled curves (ACCC), were proposed to evaluate the NCT performance. They basically have a development trend with fast speed in the beginning before Grade 1 or 2 of primary schools, and then enter an extremely slow development period (with ceiling or floor effect). SA and SpC have gender and grade main effects, while ATC and ACCC have the grade main effect, only. In particular, females have higher SA scores than males in middle class of kindergarten, and Grade 2-Grade 5 of primary school, but no gender differences in other grades; females have higher SpC scores than males in middle class of kindergarten, and Grade 3-4 of primary school, but no gender differences in other grades. More importantly, in clinical practice, if SA or SpC measure of a child is below than the 5th centile (i.e., p5 level) of his/her grade-specific normative data, then this child may be predicted to have a high-risk of learning disabilities. Findings suggest that the proposed method can be used for early screening of learning disabilities by setting appropriate cut-off values.
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Affiliation(s)
- Yachun Xie
- Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Hongan Wang
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Yuxin Chen
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Fulin Liu
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Mengmeng Yao
- Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Lei Zhang
- Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Panting Liu
- Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Qin Hong
- Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Xia Chi
- Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Dongchuan Yu
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
- Henan Provincial Medical Key Lab of Child Developmental Behavior and Learning, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Medical Key Lab of Language Rehabilitation for Children, Sanmenxia Center Hospital, Sanmenxia, China
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17
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Villarreal S, Linnavuo M, Sepponen R, Vuori O, Bonato M, Jokinen H, Hietanen M. Computer-Based Assessment: Dual-Task Outperforms Large-Screen Cancellation Task in Detecting Contralesional Omissions. Front Psychol 2022; 12:790438. [PMID: 35069375 PMCID: PMC8777372 DOI: 10.3389/fpsyg.2021.790438] [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: 10/06/2021] [Accepted: 12/09/2021] [Indexed: 11/18/2022] Open
Abstract
Objective: Traditionally, asymmetric spatial processing (i.e., hemispatial neglect) has been assessed with paper-and-pencil tasks, but growing evidence indicates that computer-based methods are a more sensitive assessment modality. It is not known, however, whether simply converting well-established paper-and-pencil methods into a digital format is the best option. The aim of the present study was to compare sensitivity in detecting contralesional omissions of two different computer-based methods: a "digitally converted" cancellation task was compared with a computer-based Visual and Auditory dual-tasking approach, which has already proved to be very sensitive. Methods: Participants included 40 patients with chronic unilateral stroke in either the right hemisphere (RH patients, N = 20) or the left hemisphere (LH patients, N = 20) and 20 age-matched healthy controls. The cancellation task was implemented on a very large format (173 cm × 277 cm) or in a smaller (A4) paper-and-pencil version. The computer-based dual-tasks were implemented on a 15'' monitor and required the detection of unilateral and bilateral briefly presented lateralized targets. Results: Neither version of the cancellation task was able to show spatial bias in RH patients. In contrast, in the Visual dual-task RH patients missed significantly more left-sided targets than controls in both unilateral and bilateral trials. They also missed significantly more left-sided than right-sided targets only in the bilateral trials of the Auditory dual-task. Conclusion: The dual-task setting outperforms the cancellation task approach even when the latter is implemented on a (large) screen. Attentionally demanding methods are useful for revealing mild forms of contralesional visuospatial deficits.
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Affiliation(s)
- Sanna Villarreal
- Division of Neuropsychology, HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Matti Linnavuo
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Raimo Sepponen
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Outi Vuori
- Division of Neuropsychology, HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mario Bonato
- Department of General Psychology, University of Padova, Padua, Italy
| | - Hanna Jokinen
- Division of Neuropsychology, HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marja Hietanen
- Division of Neuropsychology, HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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18
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Scheffels JF, Korabova S, Eling P, Kastrup A, Hildebrandt H. The Effects of Continuous vs. Intermittent Prism Adaptation Protocols for Treating Visuospatial Neglect: A Randomized Controlled Trial. Front Neurol 2021; 12:742727. [PMID: 34867725 PMCID: PMC8639507 DOI: 10.3389/fneur.2021.742727] [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] [Received: 07/16/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Visuospatial neglect may interfere with activities of daily living (ADL). Prism adaptation (PA) is one treatment option and may involve two components: recalibration (more strategic) and realignment (more implicit). We examined whether recalibration or realignment is the driving force in neglect rehabilitation using PA. In a randomized controlled trial with two recruitment series and a cross-over design, 24 neglect patients were allocated to a continuous (PA-c) or intermittent (PA-i) PA procedure. During the PA-c condition, goggles were worn without doffing. In the PA-i condition, patients donned goggles twice (first series of patients) or three times (second series) during training to induce more recalibrations. Primary outcome parameters were performance (omissions) on the Apples Cancellation Test and ADL scores. To assess the efficacy of the PA treatment, we compared effect sizes of the current study with those from three groups from previous studies at the same rehabilitation unit: (1) a passive treatment with a similar intensity, (2) a placebo treatment with a similar intensity, and (3) a PA treatment with fewer therapy sessions. Treatment conditions did not significantly predict scores on primary and most secondary outcome parameters. However, the spontaneous ipsilesional body orientation improved only in patients receiving the PA-i condition and this improvement also appeared in patients showing a strong after-effect (irrespective of condition). Effect sizes for the Apples Cancellation Test and the Functional Independence Measure were larger for both PA treatment protocols than the historical control groups. We conclude that more recalibrations during an intermittent PA treatment may have a beneficial effect on spontaneous body orientation but not on other aspects of neglect or on ADL performance. Clinical Trial Registration: German Clinical Trials Register, identifier: DRKS00018813, DRKS00021539.
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Affiliation(s)
- Jannik Florian Scheffels
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
| | - Sona Korabova
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
| | - Paul Eling
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
| | - Andreas Kastrup
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
| | - Helmut Hildebrandt
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
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19
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Left egocentric neglect in early subacute right-stroke patients is related to damage of the superior longitudinal fasciculus. Brain Imaging Behav 2021; 16:211-218. [PMID: 34328618 PMCID: PMC8825605 DOI: 10.1007/s11682-021-00493-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 11/16/2022]
Abstract
A typical consequence of stroke in the right hemisphere is unilateral spatial neglect. Distinct forms of neglect have been described, such as space-based (egocentric) and object-based (allocentric) neglect. However, the relationship between these two forms of neglect is still far from being understood, as well as their neural substrates. Here, we further explore this issue by using voxel lesion symptoms mapping (VLSM) analyses on a large sample of early subacute right-stroke patients assessed with the Apples Cancellation Test. This is a sensitive test that simultaneously measures both egocentric and allocentric neglect. Behaviourally, we found no correlation between egocentric and allocentric performance, indicating independent mechanisms supporting the two forms of neglect. This was confirmed by the VLSM analysis that pointed out a link between a damage in the superior longitudinal fasciculus and left egocentric neglect. By contrast, no association was found between brain damage and left allocentric neglect. These results indicate a higher probability to observe egocentric neglect as a consequence of white matter damages in the superior longitudinal fasciculus, while allocentric neglect appears more “globally” related to the whole lesion map. Overall, these findings on early subacute right-stroke patients highlight the role played by white matter integrity in sustaining attention-related operations within an egocentric frame of reference.
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Di Gregorio F, La Porta F, Lullini G, Casanova E, Petrone V, Simoncini L, Ferrucci E, Piperno R. Efficacy of Repetitive Transcranial Magnetic Stimulation Combined With Visual Scanning Treatment on Cognitive-Behavioral Symptoms of Unilateral Spatial Neglect in Patients With Traumatic Brain Injury: Study Protocol for a Randomized Controlled Trial. Front Neurol 2021; 12:702649. [PMID: 34335455 PMCID: PMC8317998 DOI: 10.3389/fneur.2021.702649] [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: 05/04/2021] [Accepted: 06/22/2021] [Indexed: 11/25/2022] Open
Abstract
Left hemispatial neglect (LHSN) is a frequent and disabling condition affecting patients who suffered from traumatic brain injury (TBI). LHSN is a neuropsychological syndrome characterized clinically by difficulties in attending, responding, and consciously representing the right side of space. Despite its frequency, scientific evidence on effective treatments for this condition in TBI patients is still low. According to existing literature, we hypothesize that in TBI, LHSN is caused by an imbalance in inter-hemispheric activity due to hyperactivity of the left hemisphere, as observed in LHSN after right strokes. Thus, by inhibiting this left hyperactivity, repetitive Transcranial Magnetic Stimulation (rTMS) would have a rebalancing effect, reducing LHSN symptoms in TBI patients. We plan to test this hypothesis within a single-blind, randomized SHAM controlled trial in which TBI patients will receive inhibitory i-rTMS followed by cognitive treatment for 15 days. Neurophysiological and clinical measures will be collected before, afterward, and in the follow-up. This study will give the first empirical evidence about the efficacy of a novel approach to treating LHSN in TBI patients. Clinical Trial Registration:https://www.clinicaltrials.gov/ct2/show/NCT04573413?cond=Neglect%2C+Hemispatial&cntry=IT&city=Bologna&draw=2&rank=2, identifier: NCT04573413.
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Affiliation(s)
- Francesco Di Gregorio
- Azienda Unità Sanitaria Locale, UO di Medicina Riabilitativa e Neuroriabilitazione, Bologna, Italy
| | - Fabio La Porta
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, UO di Medicina Riabilitativa e Neuroriabilitazione, Bologna, Italy
| | - Giada Lullini
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, UO di Medicina Riabilitativa e Neuroriabilitazione, Bologna, Italy
| | - Emanuela Casanova
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, UO di Medicina Riabilitativa e Neuroriabilitazione, Bologna, Italy
| | - Valeria Petrone
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, UO di Medicina Riabilitativa e Neuroriabilitazione, Bologna, Italy
| | - Loredana Simoncini
- Azienda Unità Sanitaria Locale, UO di Medicina Riabilitativa e Neuroriabilitazione, Bologna, Italy
| | - Enrico Ferrucci
- Azienda Unità Sanitaria Locale, UO di Medicina Riabilitativa e Neuroriabilitazione, Bologna, Italy
| | - Roberto Piperno
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, UO di Medicina Riabilitativa e Neuroriabilitazione, Bologna, Italy
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21
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Ciaramelli E, Anelli F, Frassinetti F. An asymmetry in past and future mental time travel following vmPFC damage. Soc Cogn Affect Neurosci 2021; 16:315-325. [PMID: 33382070 PMCID: PMC7943363 DOI: 10.1093/scan/nsaa163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/16/2020] [Accepted: 12/02/2020] [Indexed: 12/14/2022] Open
Abstract
The role of ventromedial prefrontal cortex (vmPFC) in mental time travel toward the past and the future is debated. Here, patients with focal lesions to the vmPFC and brain-damaged and healthy controls mentally projected themselves to a past, present or future moment of subjective time (self-projection) and classified a series of events as past or future relative to the adopted temporal self-location (self-reference). We found that vmPFC patients were selectively impaired in projecting themselves to the future and in recognizing relative-future events. These findings indicate that vmPFC damage hinders the mental processing of and movement toward future events, pointing to a prominent, multifaceted role of vmPFC in future-oriented mental time travel.
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Affiliation(s)
- Elisa Ciaramelli
- Department of Psychology, University of Bologna, Bologna 40126, Italy
- Center for Studies and Research of Cognitive Neuroscience, Department of Psychology, University of Bologna, Cesena 47521, Italy
| | - Filomena Anelli
- Department of Psychology, University of Bologna, Bologna 40126, Italy
- Department of Surgical and Medical Sciences, “Magna Graecia” University of Catanzaro, Catanzaro 88100, Italy
| | - Francesca Frassinetti
- Department of Psychology, University of Bologna, Bologna 40126, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Operative Unit for Recovery and Functional Rehabilitation, Institute of Castel Goffredo, Mantova 46042, Italy
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22
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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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23
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Basagni B, Luzzatti C, De Tanti A, Bozzetti F, Crisi G, Pinardi C, Errante A, Fogassi L. Some evidence on Gerstmann's syndrome: A case study on a variant of the clinical disorder. Brain Cogn 2021; 148:105679. [PMID: 33477079 DOI: 10.1016/j.bandc.2020.105679] [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: 09/20/2020] [Revised: 12/26/2020] [Accepted: 12/27/2020] [Indexed: 11/19/2022]
Abstract
We describe the case of a bilingual patient with persistent symptoms largely, although not fully, consistent with those that are usually reported in Gerstmann's syndrome. Twenty months after a spontaneous primary intracranial hemorrhage, the patient was evaluated with a series of neuropsychological tasks and underwent an MRI investigation based on Diffusion Tensor Imaging probabilistic tractography. The patient suffered from dysgraphia (difficulty in the access to the graphemic representation of letter forms), autotopoagnosia (difficulties in locating body parts on verbal command), right-left confusion (difficulties in localizing right and left side of symmetrical body parts), and number processing/calculation impairments (predominant difficulties on transcoding tasks). Probabilistic tractography revealed a relatively spared superior longitudinal fasciculus and severe damage to the subcortical white matter connecting the angular gyrus with other parietal regions, such as the intraparietal sulcus and the supramarginal gyrus. Within the framework of the contemporary cognitive accounts of Gerstmann's syndrome, the case supports the assumption of an anatomical intraparietal disconnection more than a functional Grundstörung (core impairment).
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Affiliation(s)
- Benedetta Basagni
- Cardinal Ferrari Rehabilitation Centre, S. Stefano Institute, Fontanellato, Parma, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
| | - Claudio Luzzatti
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; Milan Center for Neuroscience, Milan, Italy
| | - Antonio De Tanti
- Cardinal Ferrari Rehabilitation Centre, S. Stefano Institute, Fontanellato, Parma, Italy
| | - Francesca Bozzetti
- Neuroradiology Unit, Department of Diagnostic, Hospital and University of Parma, Parma, Italy
| | - Girolamo Crisi
- Neuroradiology Unit, Department of Diagnostic, Hospital and University of Parma, Parma, Italy
| | - Chiara Pinardi
- Neuroradiology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Antonino Errante
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Leonardo Fogassi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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Hart E, Grattan E, Woodbury M, Herbert TL, Coker-Bolt P, Bonilha H. Pediatric unilateral spatial neglect: A systematic review. J Pediatr Rehabil Med 2021; 14:345-359. [PMID: 34459422 PMCID: PMC8860031 DOI: 10.3233/prm-200779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Unilateral spatial neglect (USN), an inability to attend to one side of space or one's body, is commonly reported in adult stroke survivors and is associated with poor outcomes. USN has been reported in pediatric survivors of stroke, but its impact is unclear. The purpose of this systematic review was to summarize and evaluate the literature regarding USN in pediatric stroke survivors. METHODS PRISMA guidelines, Scopus, CINAHL, PubMed, and other relevant databases were searched with terms including "children", "stroke", and "unilateral neglect", with the ages of participants limited from to birth to 18 years. Data were extracted from studies on the clinical presentation of pediatric USN, the assessment of this condition, treatment options, or USN recovery. RESULTS A total of 18 articles met inclusion criteria. There were no current prevalence data available. USN presents similarly in children compared to adults. Several different USN assessments were used, however, there were little data regarding treatment options. Furthermore, the data suggest that not all children fully recover. CONCLUSION This systematic review reveals a lack of quality research to inform the assessment and treatment of children with USN. Although the literature spans decades, there remain no guidelines for standardized assessment or treatment. Similar to adults, paper-and-pencil testing may be less able to identify USN than functional assessments. It is likely that there are children who struggle with undetected USN-related deficits years after their injuries. With a rise of pediatric stroke survivors, there is a pressing need for clinicians to be educated about USN in children, clinical presentations, assessments, and treatments.
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Affiliation(s)
- Emerson Hart
- Department of Health Science and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
| | - Emily Grattan
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA.,VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Michelle Woodbury
- Department of Health Science and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.,Department of Occupational Therapy, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
| | - Teri Lynn Herbert
- Medical University of South Carolina Academic Affairs, Charleston, SC, USA
| | - Patty Coker-Bolt
- Department of Occupational Therapy, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
| | - Heather Bonilha
- Department of Health Science and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
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25
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Lattanzi S, Coccia M, Pulcini A, Cagnetti C, Galli FL, Villani L, Campa S, Dobran M, Polonara G, Ceravolo MG, Silvestrini M. Endovascular treatment and cognitive outcome after anterior circulation ischemic stroke. Sci Rep 2020; 10:18524. [PMID: 33116220 PMCID: PMC7595128 DOI: 10.1038/s41598-020-75609-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/13/2020] [Indexed: 11/09/2022] Open
Abstract
The impact of reperfusion therapies on cognition has been poorly explored and little knowledge exists. We explored the influence of endovascular treatment (EVT) on cognitive outcome in patients with anterior circulation ischemic stroke. Patients presenting with ischemic stroke due to anterior large vessel occlusion who underwent intravenous thrombolysis (IVT) alone or EVT plus IVT were recruited. Cognitive abilities were evaluated at 6 months from stroke through a neuropsychological test battery. A total of 88 patients with a mean age of 66.3 ± 12.9 years were included, of which 38 treated with IVT alone and 50 with IVT plus EVT. Compared to patients treated with IVT alone, patients who received EVT plus IVT performed significantly better at the neuropsychological tests exploring executive functions, attention, abstract reasoning, visuospatial ability, visual and verbal and memory. At multivariable regression analysis, the EVT was independently associated with the 6-month cognitive performance after the adjustment for age, sex, admission National Institutes of Health Stroke Scale score, systolic blood pressure, glucose level, Alberta Stroke Program Early CT score, side of stroke, site of occlusion, and Back Depression Inventory score [Stroop Test Word Reading: adjβ = 13.99, 95% confidence interval (CI) 8.47–19.50, p < 0.001; Stroop Test Colour Naming: adjβ = 6.63, 95% CI 2.46–10.81, p = 0.002; Trail Making Test-A: adjβ = − 92.98, 95% CI − 153.76 to − 32.20, p = 0.003; Trail Making Test-B: adjβ = − 181.12, 95% CI − 266.09 to − 96.15; p < 0.001; Digit Span Test Forward: adjβ = 1.44, 95% CI 0.77–2.10, p < 0.001; Digit Span Test Backward: adjβ = 1.10, 95% CI 0.42–1.77, p = 0.002; Coloured Progressive Matrices: adjβ = 5.82, 95% CI 2.71–8.93, p < 0.001; Rey Complex Figure Test-Copy: adjβ = 6.02, 95% CI 2.74–9.30, p < 0.001; Rey Complex Figure Test-Immediate recall: adjβ = 6.00, 95% CI 2.34–9.66, p = 0.002; Rey Complex Figure Test-Delayed recall: adjβ = 5.73, 95% CI 1.95–9.51, p = 0.003; Rey Auditory Verbal Learning Test-Immediate recall: adjβ = 12.60, 95% CI 6.69–18.52, p < 0.001; Rey Auditory Verbal Learning Test-Delayed recall: adjβ = 1.85, 95% CI 0.24–3.45, p = 0.025]. Patients treated with EVT plus IVT had better cognitive performance than patients treated with IVT alone at 6 months from anterior circulation ischemic stroke.
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Affiliation(s)
- Simona Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020, Ancona, Italy.
| | - Michela Coccia
- Neurorehabilitation Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Alessandra Pulcini
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020, Ancona, Italy
| | - Claudia Cagnetti
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020, Ancona, Italy
| | - Federica Lucia Galli
- Neurorehabilitation Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Laura Villani
- Neurorehabilitation Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Serena Campa
- Clinic of Neuroradiology, Marche Polytechnic University, Ancona, Italy
| | - Mauro Dobran
- Clinic of Neurosurgery, Marche Polytechnic University, Ancona, Italy
| | - Gabriele Polonara
- Clinic of Neuroradiology, Marche Polytechnic University, Ancona, Italy
| | - Maria Gabriella Ceravolo
- Neurorehabilitation Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Mauro Silvestrini
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020, Ancona, Italy
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26
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Trombini M, Vestito L, Morando M, Mori L, Trompetto C, Bandini F, Dellepiane S. Unilateral spatial neglect rehabilitation supported by a digital solution: two case-studies. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:3670-3675. [PMID: 33018797 DOI: 10.1109/embc44109.2020.9175834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Digital solutions for unilateral spatial neglect (USN) assessment and treatment are nowadays of great interest, because of both the possibility of combining them with other rehabilitation practices, and the easy-to-understand data and indicators they collect. The ReMoVES platform, developed in DITEN laboratories, is conceived in the Assistive Technologies framework and provides motor and cognitive exergames and activities to be performed in conjunction with traditional rehabilitation. In this work, two case-studies, related to the USN rehabilitation, are presented. The combination of cognitive therapy, delivered by the ReMoVES platform, and transcranial direct-current stimulation (tDCS) technique was used as rehabilitation treatment for both the patients. Data collected at the beginning or at the end of the rehabilitation process, or also during the treatment sessions, are shown and discussed in this paper. This work is a preliminary part of a wider one, that will be conducted involving many different rehabilitation centers, aimed at proving the validity of such an approach to USN treatments.
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27
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Guarracino I, Ius T, Skrap M, Tomasino B. Meningioma can lead to pre-operative cognitive alterations even if localized in sensorimotor areas: A multimodal MRI-neuropsychological study in a series of 46 patients. Neuropsychologia 2020; 137:107288. [PMID: 31790726 DOI: 10.1016/j.neuropsychologia.2019.107288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/07/2019] [Accepted: 11/28/2019] [Indexed: 11/15/2022]
Abstract
Brain tumors are generally associated with cognitive changes. Little is known about cognition in patients with meningioma - a lesion that usually shifts and compresses the brain parenchyma with a low probability of infiltrate it. We investigated the cognitive functioning in a consecutive series of 46 patients with a meningioma in the sensorimotor area in the left (LH, N = 27) or in the right (RH, N = 19) hemisphere. All the patients underwent a pre-operative neuropsychological assessment and structural MRI. Clinical symptoms varied between LH and RH meningioma patients. Impaired performance was seen in naming (19.23% noun and 35% verb naming), short-term (18.18%) and working (14.24%) memory in the LH group, and in visuo-spatial tasks (25% neglect, 21.42% visuospatial planning) in the RH group. Both groups were impaired on a sensorimotor mental imagery task (LH, 66.66% of the LH 70% of the RH meningioma patients), while only the RH meningioma group was impaired on the visuo-spatial mental imagery task. The lesion MRI maximum overlap occurred in the postcentral and paracentral lobules. Edema was maximally localized on the left superior longitudinal fasciculus and the superior part of the right superior corona radiata. We found that only the meningioma mass, and not the edema, is a predictive variable in determining patients' performance. Patients with meningioma could present with cognitive alterations at pre-surgical evaluation even if the meningioma occurs in sensorimotor areas. In the present series, a large meningioma vs. a large edema is more relevant for cognitive performance.
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Affiliation(s)
- Ilaria Guarracino
- Scientific Institute, IRCCS E. Medea, San Vito al Tagliamento, Pordenone, Italy
| | - Tamara Ius
- Unità Operativa di Neurochirurgia, Azienda Sanitaria Universitaria Integrata S. Maria della Misericordia, Udine, Italy
| | - Miran Skrap
- Unità Operativa di Neurochirurgia, Azienda Sanitaria Universitaria Integrata S. Maria della Misericordia, Udine, Italy
| | - Barbara Tomasino
- Scientific Institute, IRCCS E. Medea, San Vito al Tagliamento, Pordenone, Italy.
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28
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Effects of Prism Adaptation on Reference Systems for Extrapersonal Space in Neglect Patients. Brain Sci 2019; 9:brainsci9110327. [PMID: 31744104 PMCID: PMC6896101 DOI: 10.3390/brainsci9110327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/06/2019] [Accepted: 11/14/2019] [Indexed: 11/21/2022] Open
Abstract
Up to now, rehabilitation of unilateral spatial neglect has focused on egocentric forms of neglect, whereas less is known about the possibility to improve allocentric deficits. The present study aimed to examine the efficacy of prism adaptation (PA) training on patients with different forms of neglect: egocentric, allocentric, or mixed. Twenty-eight patients were assessed with specific neglect tests before (T0) and after (T1) 10 sessions of PA training. Performance in the Apples Cancellation test was used to identify patients with egocentric (n = 6), allocentric (n = 5), or mixed (n = 17) forms of neglect. In the overall group of patients, PA training produced significant improvements in performance across different neglect tests. In terms of the egocentric–allocentric distinction, the training was effective in reducing omissions in the left part of space in the Apples Cancellation test both for patients with egocentric neglect and mixed neglect. By contrast, errors of commissions (marking the inability to detect the left part of the target stimulus, i.e., allocentric neglect) remained unchanged after PA in patients with allocentric neglect and actually increased marginally in patients with mixed neglect. The PA training is effective in improving egocentric neglect, while it is ineffective on the allocentric form of the disturbance. Notably, the allocentric component of neglect is frequently impaired, although this is most often in conjunction with the egocentric impairment, yielding the mixed form of neglect. This stresses the importance of developing exercises tuned to improving allocentric neglect.
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29
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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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30
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Errante A, Saviola D, Fasano F, Basagni B, Alinovi S, Bosetti S, Chiari M, Minardi R, Pinardi C, Crisi G, Fogassi L, De Tanti A. Application of an Intensive Rehabilitation Program After Very Late Recovery of Consciousness: A Single-Case Neurorehabilitation and Neuroimaging Study. J Cent Nerv Syst Dis 2019; 11:1179573519843492. [PMID: 31037040 PMCID: PMC6475846 DOI: 10.1177/1179573519843492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 03/21/2019] [Indexed: 11/29/2022] Open
Abstract
Late recovery of consciousness in vegetative state is considered as an exceptional outcome and has been reported prevalently in patients who suffered a traumatic brain injury. In these patients, the benefits of prolonging the rehabilitation, aimed at the recovery of autonomy in basic everyday activities, has been demonstrated. Here, we describe the application of an intensive multi-professional rehabilitation program carried out on a young female patient, with exceptionally late recovery of consciousness, specifically, after 7 years of vegetative state due to severe brain hemorrhage. Neuropsychological and functional assessment was conducted before and after the end of the rehabilitation program. In addition, functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI)-based probabilistic tractography were performed. Two follow-up neuropsychological and functional assessments were also conducted 6 and 29 months after the conclusion of the program. Functional results showed an improvement, maintained over time, in walking with assistance, cognitive efficiency, visual acuity and visual field, dysarthria, and execution of activities of daily living. Moreover, functional and structural magnetic resonance imaging (MRI) data documented the existence of preserved neural networks involved in sensory, motor, and linguistic tasks, which in all likelihood support the recovery process. This report suggests the possibility of undertaking an intensive rehabilitation program in patients who remain for long periods in altered states of consciousness, in spite of early negative prognosis.
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Affiliation(s)
- Antonino Errante
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Donatella Saviola
- Cardinal Ferrari Rehabilitation Centre, S. Stefano Institute, Fontanellato, Italy
| | - Fabrizio Fasano
- Brain Research Imaging Centre, Cardiff University, Cardiff, UK
| | - Benedetta Basagni
- Cardinal Ferrari Rehabilitation Centre, S. Stefano Institute, Fontanellato, Italy
| | - Serena Alinovi
- Cardinal Ferrari Rehabilitation Centre, S. Stefano Institute, Fontanellato, Italy
| | - Sara Bosetti
- Cardinal Ferrari Rehabilitation Centre, S. Stefano Institute, Fontanellato, Italy
| | - Margherita Chiari
- Cardinal Ferrari Rehabilitation Centre, S. Stefano Institute, Fontanellato, Italy
| | - Rita Minardi
- Cardinal Ferrari Rehabilitation Centre, S. Stefano Institute, Fontanellato, Italy
| | - Chiara Pinardi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Girolamo Crisi
- Neuroradiology Unit, Department of Diagnostic, Hospital and University of Parma, Parma, Italy
| | - Leonardo Fogassi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Antonio De Tanti
- Cardinal Ferrari Rehabilitation Centre, S. Stefano Institute, Fontanellato, Italy
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Anelli F, Avanzi S, Damora A, Mancuso M, Frassinetti F. Mental time travel and functional daily life activities in neglect patients: Recovery effects of rehabilitation by prism adaptation. Cortex 2019; 113:141-155. [DOI: 10.1016/j.cortex.2018.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 10/19/2018] [Accepted: 12/04/2018] [Indexed: 11/28/2022]
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Mancuso M, Damora A, Abbruzzese L, Navarrete E, Basagni B, Galardi G, Caputo M, Bartalini B, Bartolo M, Zucchella C, Carboncini MC, Dei S, Zoccolotti P, Antonucci G, De Tanti A. A New Standardization of the Bells Test: An Italian Multi-Center Normative Study. Front Psychol 2019; 9:2745. [PMID: 30723446 PMCID: PMC6350444 DOI: 10.3389/fpsyg.2018.02745] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 12/19/2018] [Indexed: 12/01/2022] Open
Abstract
Objective: The Bells Test is a cancelation task that is widely used for the diagnosis of unilateral spatial neglect (USN). With the aim of fostering more reliable use of this instrument, we set out to develop new norms adjusted for the possible influence of age, gender and education. We worked on the original version of the test. Methods: Normative data were collected from 401 healthy participants aged between 20 and 80 years. Individual factors that could affect performance (i.e., gender, age, and years of education) were considered. We computed several indices on the Bells Test including an asymmetry score, an accuracy score and execution time. Multiple regression analyses (for time measures) and generalized linear models (for accuracy measures) were used to check for the influence of individual predictors of performance on the Bells Test. Results: Data indicated a significant influence of age on the accuracy score and execution time variables and a marginally significant effect of education on the accuracy score variable. Wherever appropriate, cut-offs are provided for the three dependent scores on the Bells Test corrected for age and education. Conclusion: Based on a large normative sample, the present study provides new normative data on the Bells Test, which could lead to its reliable use in the diagnosis of USN.
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Affiliation(s)
- Mauro Mancuso
- Tuscany Rehabilitation Clinic, Arezzo, Italy.,National Health Service, Azienda USL Toscana Sud Est, Siena, Italy
| | | | | | - Eduardo Navarrete
- Department of Developmental Psychology and Socialisation, University of Padua, Padua, Italy
| | | | | | | | - Brunella Bartalini
- Department of Rehabilitation, Azienda USL Toscana Nord Ovest, Camaiore, Italy
| | | | | | | | - Simona Dei
- National Health Service, Azienda USL Toscana Sud Est, Siena, Italy
| | - Pierluigi Zoccolotti
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Neuropsychology Centre, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Gabriella Antonucci
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Neuropsychology Centre, Santa Lucia Foundation IRCCS, Rome, Italy
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Jang SH, Jang WH. The different association of allocentric and egocentric neglect with dorsal and ventral pathways: A case report. Medicine (Baltimore) 2018; 97:e12394. [PMID: 30213009 PMCID: PMC6155983 DOI: 10.1097/md.0000000000012394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Egocentric neglect is characterized by responses missing on the contralateral side with respect to the viewer, while allocentric neglect is characterized in responses missing on the contralateral side with respect to the object . However, little has been reported about the neural tracts associated with egocentric and allocentric neglect. We investigated which neural tracts were involved in two types of neglect (egocentric and allocentric) in a stroke patient who showed allocentric neglect by using the Apple Cancellation test, a specialized test to distinguish between egocentric and allocentric neglect. PATIENT CONCERNS He showed good cognitive function but presented with severe neglect on the left side (A 42-year-old, right-handed male patient). He was unable to undergo even the pencil and paper test for evaluation of the severity of neglect. DIAGNOSES He was diagnosed as spontaneous intracerebral hemorrhage at the right basal ganglia and underwent conservative management at the neurosurgery department of a university hospital. INTERVENTIONS Two weeks after onset, he began rehabilitation at the rehabilitation department of the same university hospital. During a seven month rehabilitation, the patient showed significant improvement of his severe left neglect. OUTCOMES We used the Apple Cancellation test to distinguish between egocentric and allocentric neglect; the results failed to reveal egocentric neglect, however, they did reveal severe allocentric neglect. In addition, on diffusion tensor tractography (DTT) at 2 weeks after onset, the right superior longitudinal fasciculus (SLF) showed partial injury and narrowing in the parietal lobe compared to that of the left SLF. In addition, the right inferior fronto-occipital fasciculus (IFOF) was not reconstructed. By contrast, on 7-month post-onset DTT, the right SLF revealed elongation and thickening in the parietal lobe that approached similarity to that for the left SLF. However, the right IFOF was still not reconstructed. LESSONS The associations of egocentric neglect with the dorsal pathway (SLF) and the association of allocentric neglect with the ventral pathway (IFOF) in the right hemisphere were demonstrated in a stroke patient. It appears that DTT can be helpful in demonstrating both the affected pathway and the neglect type in patients with neglect.
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Affiliation(s)
- Sung Ho Jang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daemyung-dong, Nam-ku, Daegu
| | - Woo Hyuk Jang
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Hwangjo-gil, Dogye-eup, Samcheok-si, Gangwon-do, Republic of Korea
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Aravind G, Lamontagne A. Dual tasking negatively impacts obstacle avoidance abilities in post-stroke individuals with visuospatial neglect: Task complexity matters! Restor Neurol Neurosci 2018; 35:423-436. [PMID: 28697573 DOI: 10.3233/rnn-160709] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Persons with perceptual-attentional deficits due to visuospatial neglect (VSN) after a stroke are at a risk of collisions while walking in the presence of moving obstacles. The attentional burden of performing a dual-task may further compromise their obstacle avoidance performance, putting them at a greater risk of collisions. OBJECTIVE The objective of this study was to compare the ability of persons with (VSN+) and without VSN (VSN-) to dual task while negotiating moving obstacles. METHODS Twenty-six stroke survivors (13 VSN+, 13 VSN-) were assessed on their ability to (a) negotiate moving obstacles while walking (locomotor single task); (b) perform a pitch-discrimination task (cognitive single task) and (c) simultaneously perform the walking and cognitive tasks (dual task). We compared the groups on locomotor (collision rates, minimum distance from obstacle and onset of strategies) and cognitive (error rates) outcomes. RESULTS For both single and dual task walking, VSN+ individuals showed higher collision rates compared to VSN- individuals. Dual tasking caused deterioration of locomotor (more collisions, delayed onset and smaller minimum distances) and cognitive performances (higher error rate) in VSN+ individuals. Contrastingly, VSN- individuals maintained collision rates, increased minimum distance, but showed more cognitive errors, prioritizing their locomotor performance. CONCLUSION Individuals with VSN demonstrate cognitive-locomotor interference under dual task conditions, which could severely compromise safety when ambulating in community environments and may explain the poor recovery of independent community ambulation in these individuals.
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Affiliation(s)
- Gayatri Aravind
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Research cite of CRIR, Laval, QC, Canada
| | - Anouk Lamontagne
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Research cite of CRIR, Laval, QC, Canada
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Anelli F, Avanzi S, Arzy S, Mancuso M, Frassinetti F. Effects of spatial attention on mental time travel in patients with neglect. Cortex 2018; 101:192-205. [DOI: 10.1016/j.cortex.2018.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/04/2017] [Accepted: 01/17/2018] [Indexed: 11/30/2022]
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Jang SH, Jang WH. The allocentric neglect due to injury of the inferior fronto-occipital fasciculus in a stroke patient: A case report. Medicine (Baltimore) 2018; 97:e9295. [PMID: 29480825 PMCID: PMC5943847 DOI: 10.1097/md.0000000000009295] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
RATIONALE We report on a patient who developed allocentric neglect due to injury of the inferior fronto-occipital fasciculus (IFOF) following intracranial hemorrhage, diagnosed using diffusion tensor tractography (DTT). PATIENT CONCERNS Her cognition seemed normal (A 17-year-old, right-handed female patient). However, in spite of a normal visual field, her perception was missing on the left side, and she had no awareness of her deficit. She was unable to perceive the left side in each of 2 objects, regardless of position of the 2 objects, and failed at detail exploration of the left side of 1 object. In addition, the line bisection test, the most representative neglect test, did not reveal any abnormality. DIAGNOSES She was diagnosed with an intracerebral hemorrhage (right thalamus), intraventricular hemorrhage, and subarachnoid hemorrhage due to arteriovenous malformation in the right thalamus. INTERVENTIONS Seven weeks after onset, she began rehabilitation. Consequently, the apple cancellation test to discriminate between allocentric and egocentric neglect was performed, with the result of severe allocentric neglect. OUTCOMES The right superior longitudinal fasciculus and inferior longitudinal fasciculus were well-reconstructed without definite injury compared with those of the left side. However, the right IFOF was discontinued in the anterior portion around the frontal lobe. LESSONS Allocentric neglect due to injury of IFOF was demonstrated in a stroke patient using DTT. It appears that DTT would be helpful in demonstrating the neglect type and pathway in patients with neglect.
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Affiliation(s)
- Sung Ho Jang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daemyungdong, Namku, Daegu
| | - Woo Hyuk Jang
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Dogye-eup, Samcheok-si, Gangwon-do, Republic of Korea
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The assessment of hemineglect syndrome with cancellation tasks: a comparison between the Bells test and the Apples test. Neurol Sci 2017; 38:2171-2176. [PMID: 28980076 DOI: 10.1007/s10072-017-3139-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/26/2017] [Indexed: 10/18/2022]
Abstract
Unilateral spatial neglect (USN) is a frequent consequence of acquired brain injury, especially following right hemisphere damage. Traditionally, unilateral spatial neglect is assessed with cancellation tests such as the Bells test. Recently, a new cancellation test, the Apples test, has been proposed. The present study aims at comparing the accuracy of these two tests in detecting hemispatial neglect, on a sample of 56 right hemisphere stroke patients with a diagnosis of USN. In order to evaluate the agreement between the Apples and Bells tests, Cohen's kappa and McNemar's test were used to assess differences between the two methods of evaluation. Poor agreement and statistically significant differences emerged between the Apples and Bells tests. Overall, the Apples test was significantly more sensitive than the Bells test in detecting USN. Based on these results, the use of the Apples test for peripersonal neglect assessment is therefore highly recommended.
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