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Rich TJ, Pylarinos M, Parrott D, Chen P. Prism Adaptation Treatment for Right-Sided and Left-Sided Spatial Neglect: A Retrospective Case-Matched Study. Arch Rehabil Res Clin Transl 2023; 5:100263. [PMID: 37312976 PMCID: PMC10258371 DOI: 10.1016/j.arrct.2023.100263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Objective To compare the effectiveness of prism adaptation treatment (PAT) between patients with right- and left-sided spatial neglect (SN). Design Retrospective case-matched design. Setting Inpatient rehabilitation hospitals and facilities. Participants A total of 118 participants were selected from a clinical dataset of 4256 patients from multiple facilities across the United States. Patients with right-sided SN (median age: 71.0 [63.5-78.5] years; 47.5% female; 84.8% stroke, 10.1% traumatic/nontraumatic brain injury) were matched 1:1 with patients with left-sided SN (median age: 70.0 [63.0-78.0] years; 49.2% female; 86.4% stroke, 11.8% traumatic/nontraumatic brain injury) based on age, neglect severity, overall functional ability at admission, and number of PAT sessions completed during their hospital stay. Intervention Prism adaptation treatment. Main Outcome Measures Primary outcomes were pre-post change on the Kessler Foundation Neglect Assessment Process (KF-NAP) and the Functional Independence Measure (FIM). Secondary outcomes were whether the minimal clinically important difference was achieved for pre-post change on the FIM. Results We found greater KF-NAP gain for patients with right-sided SN than those with left-sided SN (Z = 2.38, P=.018). We found no differences between patients with right-sided and left-sided SN for Total FIM gain (Z=-0.204, P=.838), Motor FIM gain (Z=-0.331, P=.741), or Cognitive FIM gain (Z=-0.191, P=.849). Conclusions Our findings suggest PAT is a viable treatment for patients with right-sided SN just as it is for patients with left-sided SN. Therefore, we suggest prioritizing PAT within the inpatient rehabilitation setting as a treatment to improve SN symptoms regardless of brain lesion side.
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Affiliation(s)
- Timothy J. Rich
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
- Rutgers New Jersey Medical School, Newark, NJ
| | | | - Devan Parrott
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN
- Research, Training, and Outcome Center for Brain Injury, Rehabilitation Hospital of Indiana, Indianapolis, IN
| | - Peii Chen
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
- Rutgers New Jersey Medical School, Newark, NJ
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Danesin L, Oliveri M, Semenza C, Bottini G, Burgio F, Giustiniani A. Prism adaptation in patients with unilateral lesion of the parietal or cerebellar cortex: A pilot study on two single cases using a concurrent exposure procedure. Neuropsychologia 2023; 184:108557. [PMID: 37011723 DOI: 10.1016/j.neuropsychologia.2023.108557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023]
Abstract
Neuroimaging studies showed that prism adaptation (PA), a widely used tool for the rehabilitation of neglect, involves a wide network of brain regions including the parietal cortex and the cerebellum. In particular, the parietal cortex has been suggested to mediate the initial stage of PA through conscious compensatory mechanisms as a reaction to the deviation induced by PA. The cerebellum, on the other side, intervenes in sensory errors prediction to update internal models in later stages. It has been suggested that two mechanisms may underlie PA effects: recalibration, a strategic cognitive process occurring in the initial stages of PA, and realignment, a fully automatic reorganization of spatial maps emerging later and more slowly in time. The parietal lobe has been proposed to be involved mainly in the recalibration whereas the realignment would be carried over by the cerebellum. Previous studies have investigated the effects of a lesion involving either the cerebellum or the parietal lobe in PA taking into account both realignment and recalibration processes. Conversely, no studies have compared the performance of a patient with a cerebellar lesion to that of a patient with a parietal lesion. In the present study, we used a recently developed technique for digital PA to test differences in visuomotor learning after a single session of PA in a patient with parietal and a patient with cerebellar lesions, respectively. The PA procedure, in this case, includes a digital pointing task based on a concurrent exposure technique, which allows patients to fully see their arm during the pointing task. This procedure has been shown to be as effective as the terminal exposure condition in neglect rehabilitation albeit different processes take place during concurrent exposure condition compared to the most used terminal exposure (allowing to see only the final part of the movement). Patients' performances were compared to that of a control group. A single session of PA was administered to 1) a patient (BC) with left parieto-occipital lesion involving SPL and IPL, 2) a patient (TGM) with a stroke in the territory sub-served by the SCA in the cerebellum, and 3) 14 healthy controls (HC). The task included three conditions: before wearing prismatic goggles (pre-exposure), while wearing prisms (exposure) and after removing the goggles (post-exposure). Mean deviations were calculated for the following phases: pre-exposure, early-exposure, late-exposure, post-exposure. The presence of after-effect was calculated as the difference between pre-exposure and post-exposure conditions. For each of these conditions, patients' performance was compared to that of the control group by using a modified Crawford t-test. We found that the patient with the parietal lesion had a significantly different performance in the late-exposure and in the post-exposure compared to both HC and the patient with the cerebellar lesion. Conversely, no differences were observed between TGM and HC across all the conditions. Our results show an increase in the magnitude of the adaptation during the late stage of PA in the patient with the parietal lesion whereas no differences in the performance between the cerebellar patient and the controls were found. These results confirm previous studies suggesting that the parietal cortex is an important node of a wider network involved in PA effect. Furthermore, results in the cerebellar patient suggest that visuomotor learning is not affected by lesions of the SCA territory when a concurrent exposure is used as, in such case, it less relies on sensory errors prediction to update internal models. Results are discussed considering the novelty of the applied PA technique.
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Affiliation(s)
- L Danesin
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy.
| | - M Oliveri
- Department SPPEF, University of Palermo, Italy.
| | - C Semenza
- ERN Neuromuscular Center, Department of Neurosciences, University of Padova, 35129, Padova, Italy.
| | - G Bottini
- Department of Brain and Behavioral Science, University of Pavia, 27100, Pavia, Italy; ASST GOM Niguarda, Milan, Italy; NeuroMI, Milan, Italy.
| | - F Burgio
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy.
| | - A Giustiniani
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy.
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Farron N, Clarke S, Crottaz-Herbette S. Does hand modulate the reshaping of the attentional system during rightward prism adaptation? An fMRI study. Front Psychol 2022; 13:909815. [PMID: 35967619 PMCID: PMC9363778 DOI: 10.3389/fpsyg.2022.909815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/30/2022] [Indexed: 11/18/2022] Open
Abstract
Adaptation to right-deviating prisms (R-PA), that is, learning to point with the right hand to targets perceived through prisms, has been shown to change spatial topography within the inferior parietal lobule (IPL) by increasing responses to left, central, and right targets on the left hemisphere and decreasing responses to right and central targets on the right hemisphere. As pointed out previously, this corresponds to a switch of the dominance of the ventral attentional network from the right to the left hemisphere. Since the encoding of hand movements in pointing paradigms is side-dependent, the choice of right vs. left hand for pointing during R-PA may influence the visuomotor adaptation process and hence the reshaping of the attentional system. We have tested this hypothesis in normal subjects by comparing activation patterns to visual targets in left, central, and right fields elicited before and after adaptation to rightward-deviating prisms using the right hand (RWRH) with those in two control groups. The first control group underwent adaptation to rightward-deviating prisms using the left hand, whereas the second control group underwent adaptation to leftward-deviating prisms using the right hand. The present study confirmed the previously described enhancement of left and central visual field representation within left IPL following R-PA. It further showed that the use of right vs. left hand during adaptation modulates this enhancement in some but not all parts of the left IPL. Interestingly, in some clusters identified in this study, L-PA with right hand mimics partially the effect of R-PA by enhancing activation elicited by left stimuli in the left IPL and by decreasing activation elicited by right stimuli in the right IPL. Thus, the use of right vs. left hand modulates the R-PA-induced reshaping of the ventral attentional system. Whether the choice of hand during R-PA affects also the reshaping of the dorsal attentional system remains to be determined as well as possible clinical applications of this approach. Depending on the patients' conditions, using the right or the left hand during PA might potentiate the beneficial effects of this intervention.
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Turriziani P, Chiaramonte G, Mangano GR, Bonaventura RE, Smirni D, Oliveri M. Improvement of phonemic fluency following leftward prism adaptation. Sci Rep 2021; 11:7313. [PMID: 33790347 PMCID: PMC8012568 DOI: 10.1038/s41598-021-86625-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 03/15/2021] [Indexed: 11/19/2022] Open
Abstract
Anatomo functional studies of prism adaptation (PA) have been shown to modulate a brain frontal-parieto-temporal network, increasing activation of this network in the hemisphere ipsilateral to the side of prism deviation. This effect raises the hypothesis that left prism adaptation, modulating frontal areas of the left hemisphere, could modify subjects’ performance on linguistic tasks that map on those areas. To test this hypothesis, 51 healthy subjects participated in experiments in which leftward or rightward prism adaptation were applied before the execution of a phonemic fluency task, i.e., a task with strict left hemispheric lateralization onto frontal areas. Results showed that leftward PA significantly increased the number of words produced whereas rightward PA did not significantly modulate phonemic fluency. The present findings document modulation of a language ability following prism adaptation. The results could have a huge clinical impact in neurological populations, opening new strategies of intervention for language and executive dysfunctions.
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Affiliation(s)
- Patrizia Turriziani
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Viale delle Scienze, Ed. 15, 90128, Palermo, Italy.,NeuroTeam Life and Science, Palermo, Italy
| | - Gabriele Chiaramonte
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Viale delle Scienze, Ed. 15, 90128, Palermo, Italy
| | - Giuseppa Renata Mangano
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Viale delle Scienze, Ed. 15, 90128, Palermo, Italy.,NeuroTeam Life and Science, Palermo, Italy
| | - Rosario Emanuele Bonaventura
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Viale delle Scienze, Ed. 15, 90128, Palermo, Italy
| | - Daniela Smirni
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Viale delle Scienze, Ed. 15, 90128, Palermo, Italy
| | - Massimiliano Oliveri
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Viale delle Scienze, Ed. 15, 90128, Palermo, Italy. .,NeuroTeam Life and Science, Palermo, Italy.
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Terruzzi S, Crivelli D, Pisoni A, Mattavelli G, Romero Lauro LJ, Bolognini N, Vallar G. The role of the right posterior parietal cortex in prism adaptation and its aftereffects. Neuropsychologia 2020; 150:107672. [PMID: 33188788 DOI: 10.1016/j.neuropsychologia.2020.107672] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 06/26/2020] [Accepted: 11/04/2020] [Indexed: 11/28/2022]
Abstract
Adaptation to optical prisms (Prismatic Adaptation, PA) displacing the visual scene laterally, on one side of visual space, is both a procedure for investigating visuo-motor plasticity and a powerful tool for the rehabilitation of Unilateral Spatial Neglect (USN). Two processes are involved in PA: i) recalibration (the reduction of the error of manual pointings toward the direction of the prism-induced displacement of the visual scene); ii) the successive realignment after prisms' removal, indexed by the Aftereffects (AEs, in egocentric straight-ahead pointing tasks, the deviation in a direction opposite to the visual displacement previously induced by prisms). This study investigated the role of the posterior parietal cortex (PPC) of the right hemisphere in PA and AEs, by means of low frequency repetitive Transcranial Magnetic Stimulation (rTMS). Proprioceptive and Visuo-proprioceptive egocentric straight-ahead pointing tasks were used to assess the presence and magnitude of AEs. The primary right visual cortex (V1) was also stimulated, to assess the selectivity of the PPC effects on the two processes of PA (recalibration and realignment) in comparison with a cortical region involved in visual processing. Results showed a slower adaptation to prisms when rTMS was delivered before PA, regardless of target site (right PPC or V1). AEs were reduced only by PPC rTMS applied before or after PA, as compared to a sham stimulation. These findings suggest a functional and neural dissociation between realignment and recalibration. Indeed, PA interference was induced by rTMS to both the PPC and V1, indicating that recalibration is supported by a parieto-occipital network. Conversely, AEs were disrupted only by rTMS delivered to the PPC, thus unveiling a relevant role of this region in the development and maintenance of the realignment.
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Affiliation(s)
- Stefano Terruzzi
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; CeRiN, Unversity of Trento, Rovereto, Italy.
| | - Damiano Crivelli
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Alberto Pisoni
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | | | - Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Vallar
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy.
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Zigiotto L, Damora A, Albini F, Casati C, Scrocco G, Mancuso M, Tesio L, Vallar G, Bolognini N. Multisensory stimulation for the rehabilitation of unilateral spatial neglect. Neuropsychol Rehabil 2020; 31:1410-1443. [PMID: 32558611 DOI: 10.1080/09602011.2020.1779754] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Unilateral spatial neglect (USN) is a neuropsychological syndrome, typically caused by lesions of the right hemisphere, whose features are the defective report of events occurring in the left (contralesional) side of space and the inability to orient and set up actions leftwards. Multisensory integration mechanisms, largely spared in USN patients, may temporally modulate spatial orienting. In this pilot study, the effects of an intensive audio-visual Multisensory Stimulation (MS) on USN were assessed, and compared with those of a treatment that ameliorates USN, Prismatic Adaptation (PA). Twenty USN stroke patients received a 2-week treatment (20 sessions, twice per day) of MS or PA. The effects of MS and PA were assessed by a set of neuropsychological clinical tests (target cancellation, line bisection, sentence reading, personal neglect, complex drawing) and the Catherine Bergego Scale for functional disability. Results showed that MS brought about an amelioration of USN deficits overall comparable to that induced by PA; personal neglect was improved only by MS, not by PA. The clinical gains of the MS treatment were not influenced by duration of disease and lesion volume, and they persisted up to one month post-treatment. In conclusion, MS represents a novel and promising rehabilitation procedure for USN.
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Affiliation(s)
- Luca Zigiotto
- Department of Psychology & Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milan, Italy.,Division of Neurosurgery, Santa Chiara Hospital, Trento, Italy
| | - Alessio Damora
- Department of Psychology & Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milan, Italy.,Tuscany Rehabilitation Clinic, Arezzo, Italy
| | - Federica Albini
- Department of Psychology & Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milan, Italy.,Clinical Neuropsychology Unit, Rehabilitation Department, S. Antonio Abate Hospital, Gallarate, Italy
| | - Carlotta Casati
- Laboratory of Neuropsychology, Istituto Auxologico Italiano, IRCCS, Milan, Italy.,Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Gessica Scrocco
- Department of Psychology & Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milan, Italy.,Tuscany Rehabilitation Clinic, Arezzo, Italy
| | - Mauro Mancuso
- Tuscany Rehabilitation Clinic, Arezzo, Italy.,Physical and Rehabilitative Medicine Unit, NHS South-Est Tuscany, Grossetto, Italy
| | - Luigi Tesio
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, Milan, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giuseppe Vallar
- Department of Psychology & Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milan, Italy.,Laboratory of Neuropsychology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Nadia Bolognini
- Department of Psychology & Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milan, Italy.,Laboratory of Neuropsychology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
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7
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Nijboer T, Kitazawa S, Rossetti Y. Prism adaptation: Reflections and future shifts for circular translational research? Cortex 2020; 126:213-216. [PMID: 32088409 DOI: 10.1016/j.cortex.2020.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 11/26/2019] [Accepted: 01/06/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Tanja Nijboer
- Experimental Psychology, Utrecht University, 3584, CS Utrecht, the Netherlands; Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, 3583, TM Utrecht, the Netherlands.
| | - Shigeru Kitazawa
- Graduate School of Frontier Biosciences, Osaka University, Osaka, Japan
| | - Yves Rossetti
- Inserm, CNRS, Université de Lyon, Lyon Neuroscience research Centre, Hoispices Civils de lyon, Impact, Bron, France.
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