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Ptak R, Bourgeois A. Disengagement of attention with spatial neglect: A systematic review of behavioral and anatomical findings. Neurosci Biobehav Rev 2024; 160:105622. [PMID: 38490498 DOI: 10.1016/j.neubiorev.2024.105622] [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: 11/20/2023] [Revised: 02/10/2024] [Accepted: 03/11/2024] [Indexed: 03/17/2024]
Abstract
The present review examined the consequences of focal brain injury on spatial attention studied with cueing paradigms, with a particular focus on the disengagement deficit, which refers to the abnormal slowing of reactions following an ipsilesional cue. Our review supports the established notion that the disengagement deficit is a functional marker of spatial neglect and is particularly pronounced when elicited by peripheral cues. Recent research has revealed that this deficit critically depends on cues that have task-relevant characteristics or are associated with negative reinforcement. Attentional capture by task-relevant cues is contingent on damage to the right temporo-parietal junction (TPJ) and is modulated by functional connections between the TPJ and the right insular cortex. Furthermore, damage to the dorsal premotor or prefrontal cortex (dPMC/dPFC) reduces the effect of task-relevant cues. These findings support an interactive model of the disengagement deficit, involving the right TPJ, the insula, and the dPMC/dPFC. These interconnected regions play a crucial role in regulating and adapting spatial attention to changing intrinsic values of stimuli in the environment.
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Affiliation(s)
- Radek Ptak
- Laboratory of Cognitive Neurorehabilitation, Faculty of Medicine, University of Geneva, Geneva 1206, Switzerland; Division of Neurorehabilitation, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva 1205, Switzerland.
| | - Alexia Bourgeois
- Laboratory of Cognitive Neurorehabilitation, Faculty of Medicine, University of Geneva, Geneva 1206, Switzerland; University of Applied Sciences and Arts of Western Switzerland, School of Health Sciences, Avenue de Champel 47, Geneva 1206, Switzerland
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Geiser N, Kaufmann BC, Knobel SEJ, Cazzoli D, Nef T, Nyffeler T. Comparison of uni- and multimodal motion stimulation on visual neglect: A proof-of-concept study. Cortex 2024; 171:194-203. [PMID: 38007863 DOI: 10.1016/j.cortex.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/31/2023] [Accepted: 10/16/2023] [Indexed: 11/28/2023]
Abstract
Spatial neglect is characterized by the failure to attend stimuli presented in the contralesional space. Typically, the visual modality is more severely impaired than the auditory one. This dissociation offers the possibility of cross-modal interactions, whereby auditory stimuli may have beneficial effects on the visual modality. A new auditory motion stimulation method with music dynamically moving from the right to the left hemispace has recently been shown to improve visual neglect. The aim of the present study was twofold: a) to compare the effects of unimodal auditory against visual motion stimulation, i.e., smooth pursuit training, which is an established therapeutical approach in neglect therapy and b) to explore whether a combination of auditory + visual motion stimulation, i.e., multimodal motion stimulation, would be more effective than unimodal auditory or visual motion stimulation. 28 patients with left-sided neglect due to a first-ever, right-hemispheric subacute stroke were included. Patients either received auditory, visual, or multimodal motion stimulation. The between-group effect of each motion stimulation condition as well as a control group without motion stimulation was investigated by means of a one-way ANOVA with the patient's visual exploration behaviour as an outcome variable. Our results showed that unimodal auditory motion stimulation is equally effective as unimodal visual motion stimulation: both interventions significantly improved neglect compared to the control group. Multimodal motion stimulation also significantly improved neglect, however, did not show greater improvement than unimodal auditory or visual motion stimulation alone. Besides the established visual motion stimulation, this proof-of-concept study suggests that auditory motion stimulation seems to be an alternative promising therapeutic approach to improve visual attention in neglect patients. Multimodal motion stimulation does not lead to any additional therapeutic gain. In neurorehabilitation, the implementation of either auditory or visual motion stimulation seems therefore reasonable.
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Affiliation(s)
- Nora Geiser
- Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland
| | - Brigitte Charlotte Kaufmann
- Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland; Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | | | - Dario Cazzoli
- Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland; Department of Psychology, University of Bern, Bern, Switzerland
| | - Tobias Nef
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland; Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland; Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas Nyffeler
- Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland; Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Long J, Zhang Y, Liu X, Gao Q, Pan M. Music-based interventions for unilateral spatial neglect: A systematic review. Neuropsychol Rehabil 2023; 33:1462-1487. [PMID: 35980394 DOI: 10.1080/09602011.2022.2111314] [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: 03/04/2022] [Accepted: 08/04/2022] [Indexed: 10/15/2022]
Abstract
This study aimed to evaluate the effects of music-based interventions on unilateral spatial neglect. Five databases were retrieved prior to May 5, 2022. A range of study designs were considered, including randomized controlled trials, controlled clinical trials, cohorts, and case series/reports. Types of music-based interventions were not limited. Methodological quality of randomized trials were evaluated using the RoB 2 tool, and the RoBiNT scale was utilized to assess the quality of case studies. Two authors independently summarized main results for assessments. Search strategies identified 186 potentially relevant articles, and 10 articles were collected for in-depth analysis. Preliminary results showed that USN patients performed better in cancellation tests than bisection tests after music-based intervention. In summary, pleasant music listening may have a beneficial effect on the visual attention of USN patients, and it can be hypothesized that this is related to the positive mood and emotions of patients induced by music. Music with a dynamic auditory stimulus as a new music listening programme in USN rehabilitation is worthy of further investigation. Instrument playing intervention can be considered as a multisensory stimulation to ameliorate neglect performance via multiple mechanisms. However, current results only support the short-term positive effects of music-based interventions on USN.
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Affiliation(s)
- Junzi Long
- School of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, People's Republic of China
| | - Yasu Zhang
- School of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, People's Republic of China
| | - Xiaomin Liu
- School of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, People's Republic of China
| | - Qian Gao
- School of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, People's Republic of China
| | - Mengyang Pan
- School of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, People's Republic of China
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Kaufmann BC, Cazzoli D, Bartolomeo P, Geiser N, Nef T, Nyffeler T. Response to the Letter by Schenke et al. on "Auditory spatial cueing reduces neglect after righthemispheric stroke: A proof of concept study" by Kaufmann et al., 2022. Cortex 2022; 157:336-337. [PMID: 36307350 DOI: 10.1016/j.cortex.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 12/15/2022]
Affiliation(s)
- B C Kaufmann
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France; Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland
| | - D Cazzoli
- Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland; Department of Psychology, University of Bern, Bern, Switzerland
| | - P Bartolomeo
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | - N Geiser
- Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - T Nef
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - T Nyffeler
- Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland; Perception and Eye Movement Laboratory, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
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Commentary on the article "Auditory spatial cueing reduces neglect after right-hemispheric stroke: A proof of concept study" by. Cortex 2022; 157:334-335. [PMID: 36175186 DOI: 10.1016/j.cortex.2022.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/02/2022] [Indexed: 12/15/2022]
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Knobel SEJ, Kaufmann BC, Geiser N, Gerber SM, Müri RM, Nef T, Nyffeler T, Cazzoli D. Effects of Virtual Reality-Based Multimodal Audio-Tactile Cueing in Patients With Spatial Attention Deficits: Pilot Usability Study. JMIR Serious Games 2022; 10:e34884. [PMID: 35612894 PMCID: PMC9178455 DOI: 10.2196/34884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/17/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Virtual reality (VR) devices are increasingly being used in medicine and other areas for a broad spectrum of applications. One of the possible applications of VR involves the creation of an environment manipulated in a way that helps patients with disturbances in the spatial allocation of visual attention (so-called hemispatial neglect). One approach to ameliorate neglect is to apply cross-modal cues (ie, cues in sensory modalities other than the visual one, eg, auditory and tactile) to guide visual attention toward the neglected space. So far, no study has investigated the effects of audio-tactile cues in VR on the spatial deployment of visual attention in neglect patients. OBJECTIVE This pilot study aimed to investigate the feasibility and usability of multimodal (audio-tactile) cueing, as implemented in a 3D VR setting, in patients with neglect, and obtain preliminary results concerning the effects of different types of cues on visual attention allocation compared with noncued conditions. METHODS Patients were placed in a virtual environment using a head-mounted display (HMD). The inlay of the HMD was equipped to deliver tactile feedback to the forehead. The task was to find and flag appearing birds. The birds could appear at 4 different presentation angles (lateral and paracentral on the left and right sides), and with (auditory, tactile, or audio-tactile cue) or without (no cue) a spatially meaningful cue. The task usability and feasibility, and 2 simple in-task measures (performance and early orientation) were assessed in 12 right-hemispheric stroke patients with neglect (5 with and 7 without additional somatosensory impairment). RESULTS The new VR setup showed high usability (mean score 10.2, SD 1.85; maximum score 12) and no relevant side effects (mean score 0.833, SD 0.834; maximum score 21). A repeated measures ANOVA on task performance data, with presentation angle, cue type, and group as factors, revealed a significant main effect of cue type (F30,3=9.863; P<.001) and a significant 3-way interaction (F90,9=2.057; P=.04). Post-hoc analyses revealed that among patients without somatosensory impairment, any cue led to better performance compared with no cue, for targets on the left side, and audio-tactile cues did not seem to have additive effects. Among patients with somatosensory impairment, performance was better with both auditory and audio-tactile cueing than with no cue, at every presentation angle; conversely, tactile cueing alone had no significant effect at any presentation angle. Analysis of early orientation data showed that any type of cue triggered better orientation in both groups for lateral presentation angles, possibly reflecting an early alerting effect. CONCLUSIONS Overall, audio-tactile cueing seems to be a promising method to guide patient attention. For instance, in the future, it could be used as an add-on method that supports attentional orientation during established therapeutic approaches.
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Affiliation(s)
| | - Brigitte Charlotte Kaufmann
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute (ICM), Inserm, Centre national de la recherche scientifique, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Nora Geiser
- Neurocenter, Luzerner Kantonsspital, Luzern, Switzerland
| | | | - René M Müri
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tobias Nef
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Thomas Nyffeler
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland
- Neurocenter, Luzerner Kantonsspital, Luzern, Switzerland
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Dario Cazzoli
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland
- Neurocenter, Luzerner Kantonsspital, Luzern, Switzerland
- Institute of Psychology, University of Bern, Bern, Switzerland
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