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Conte G, Quadrana L, Zotti L, Di Garbo A, Oliveri M. Prismatic adaptation coupled with cognitive training as novel treatment for developmental dyslexia: a randomized controlled trial. Sci Rep 2024; 14:7148. [PMID: 38531968 DOI: 10.1038/s41598-024-57499-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/19/2024] [Indexed: 03/28/2024] Open
Abstract
Despite intense and costly treatments, developmental dyslexia (DD) often persists into adulthood. Several brain skills unrelated to speech sound processing (i.e., phonology), including the spatial distribution of visual attention, are abnormal in DD and may represent possible treatment targets. This study explores the efficacy in DD of rightward prismatic adaptation (rPA), a visuomotor adaptation technique that enables visuo-attentive recalibration through shifts in the visual field induced by prismatic goggles. A digital intervention of rPA plus cognitive training was delivered weekly over 10 weeks to adolescents with DD (aged 13-17) assigned either to treatment (N = 35) or waitlist (N = 35) group. Efficacy was evaluated by repeated measures MANOVA assessing changes in working memory index (WMI), processing speed index (PSI), text reading speed, and words/pseudowords reading accuracy. rPA treatment was significantly more effective than waitlist (p ≤ 0.001; ηp2 = 0.815). WMI, PSI, and reading speed increased in the intervention group only (p ≤ 0.001, ηp2 = 0.67; p ≤ 0.001, ηp2 = 0.58; p ≤ 0.001, ηp2 = 0.29, respectively). Although modest change was detected for words and pseudowords accuracy in the waitlist group only (words: p ≤ 0.001, d = 0.17, pseudowords: p = 0.028; d = 0.27), between-group differences were non-significant. rPA-coupled cognitive training enhances cognitive and reading abilities in adolescents with DD. This innovative approach could have implications for early remedial treatment.
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Affiliation(s)
- Giulia Conte
- Child and Adolescent Neuropsychiatry Division, Department of Human Neuroscience, Sapienza University of Rome, 108 via dei Sabelli, 00185, Rome, Italy.
| | - Lauro Quadrana
- Child and Adolescent Neuropsychiatry Division, Department of Human Neuroscience, Sapienza University of Rome, 108 via dei Sabelli, 00185, Rome, Italy
| | - Lilian Zotti
- Child and Adolescent Neuropsychiatry Division, Department of Human Neuroscience, Sapienza University of Rome, 108 via dei Sabelli, 00185, Rome, Italy
| | - Agnese Di Garbo
- NeuroTeam Life & Science, 112 via della Libertà, 90143, Palermo, Italy
| | - Massimiliano Oliveri
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, 129 via del Vespro, 90127, Palermo, Italy
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Székely O, Ten Brink AF, Mitchell AG, Bultitude JH, McIntosh RD. No short-term treatment effect of prism adaptation for spatial neglect: An inclusive meta-analysis. Neuropsychologia 2023; 189:108566. [PMID: 37149126 DOI: 10.1016/j.neuropsychologia.2023.108566] [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: 09/28/2022] [Revised: 03/31/2023] [Accepted: 04/17/2023] [Indexed: 05/08/2023]
Abstract
Despite 25 years of research on the topic, there is still no consensus on whether prism adaptation is an effective therapy for visuospatial neglect. We have addressed this question through a meta-analysis of the most well-controlled studies on the topic. Our main meta-analytic model included studies with a placebo/sham/treatment-as-usual control group from which data from right hemisphere stroke patients and left-sided neglect could be aggregated. The short-term treatment effects on the two commonly used standard tests for neglect, the conventional Behavioural Inattention Test (BIT-C) and cancellation test scores were combined into one random effect model justified by the fact that 89% of the BIT-C score is determined by cancellation tasks. With this approach, we were able to obtain a larger and more homogeneous dataset than previous meta-analyses: sixteen studies including 430 patients. No evidence for beneficial effects of prism adaptation was found. The secondary meta-analysis including data from the Catherine Bergego Scale, a functional measure of activities of daily living, also found no evidence for the therapeutic effects of prism adaptation, although half as many studies were available for this analysis. The results were consistent after the removal of influential outliers, after studies with high risk-of-bias were excluded, and when an alternative measure of effect size was considered. These results do not support the routine use of prism adaptation as a therapy for spatial neglect.
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Affiliation(s)
- Orsolya Székely
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK; Department of Psychology, University of Bath, Claverton Down Road, Bath, Somerset, BA2 7AY, UK.
| | - Antonia F Ten Brink
- Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 8, 3584, CS Utrecht, the Netherlands; Department of Psychology, University of Bath, Claverton Down Road, Bath, Somerset, BA2 7AY, UK; Centre for Pain Research, University of Bath, Claverton Down Road, Bath, Somerset, BA2 7AY, UK
| | - Alexandra G Mitchell
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK; Center of Functionally Integrative Neuroscience, Aarhus University, 1710, Universitetsbyen 3, 8000, Aarhus, Denmark
| | - Janet H Bultitude
- Department of Psychology, University of Bath, Claverton Down Road, Bath, Somerset, BA2 7AY, UK; Centre for Pain Research, University of Bath, Claverton Down Road, Bath, Somerset, BA2 7AY, UK
| | - Robert D McIntosh
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
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Lunven M, Toba MN, Bartolomeo P. Prism adaptation therapy in spatial neglect: The importance of connectional anatomy. Neuropsychologia 2023; 188:108640. [PMID: 37423424 DOI: 10.1016/j.neuropsychologia.2023.108640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
The meta-analysis conducted by Székely et al. described the lack of beneficial effect of prism adaptation in neglect patients. The authors concluded that the results did "not support the routine use of prism adaptation as a therapy for spatial neglect". However, a possible nuance to this conclusion could be that the response (or lack thereof) of neglect patients to prism adaptation may actually depend on the connectional anatomy of their lesion. We develop this idea in our commentary, in order to offer a more balanced perspective on the implications of the findings obtained by Székely et al.
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Affiliation(s)
- Marine Lunven
- Département D'Etudes Cognitives, École Normale Supérieure, PSL University, 75005, Paris, France; University Paris Est Creteil, INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, F-94010, Creteil, France
| | - Monica N Toba
- Laboratory of Functional Neurosciences (UR UPJV 4559), University of Picardy Jules Verne and University Hospital of Amiens, Amiens, France; Sorbonne Université, Inserm U 1127, CNRS UMR 7225, Paris Brain Institute, ICM, Hôpital de La Pitié-Salpêtrière, 75013, Paris, France
| | - Paolo Bartolomeo
- Sorbonne Université, Inserm U 1127, CNRS UMR 7225, Paris Brain Institute, ICM, Hôpital de La Pitié-Salpêtrière, 75013, Paris, France.
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Aziz JR, Eskes GA. Investigating premotor reaching biases after prism adaptation. Neuropsychol Rehabil 2023:1-25. [PMID: 37599401 DOI: 10.1080/09602011.2023.2247153] [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: 02/06/2023] [Accepted: 08/01/2023] [Indexed: 08/22/2023]
Abstract
Prism adaptation (PA) is both a visuomotor learning task and potential treatment for spatial neglect after stroke. While PA's aftereffects can improve neglect symptoms, therapeutic benefits vary across individuals, possibly due to differences in neglect subtypes. Neglect symptoms can be described along an information processing pathway, yielding perceptual (input) and premotor (output) neglect subtypes. There is some evidence that PA mainly benefits persons with premotor neglect. We investigated whether PA modulates the premotor stage of information processing by examining whether PA could induce a premotor bias in healthy adults. We measured perceptual and premotor biases using a speeded reach task that compares the initiation time of leftward and rightward reaches to lateralized targets from different hand start positions. Using a randomized mixed experimental design, 30 right-handed healthy adults completed this speeded reach task before and after either left-shifting (n = 15) or right-shifting (n = 15) PA. As hypothesized, left-shifting PA speeded initiation time specifically for reaches in the rightward direction, regardless of target location (p = .02, ηp2 = .18), suggesting that PA induced a premotor bias in the direction of the prism aftereffect. These findings have implications for PA's underlying mechanisms, which can inform visuomotor learning theories and PA's use as a treatment for spatial neglect.
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Affiliation(s)
- Jasmine R Aziz
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, Canada
| | - Gail A Eskes
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Canada
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Carter AR, Barrett A. Recent advances in treatment of spatial neglect: networks and neuropsychology. Expert Rev Neurother 2023; 23:587-601. [PMID: 37273197 PMCID: PMC10740348 DOI: 10.1080/14737175.2023.2221788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Spatial neglect remains an underdiagnosed and undertreated consequence of stroke that imposes significant disability. A growing appreciation of brain networks involved in spatial cognition is helping us to develop a mechanistic understanding of different therapies under development. AREAS COVERED This review focuses on neuromodulation of brain networks for the treatment of spatial neglect after stroke, using evidence-based approaches including 1) Cognitive strategies that are more likely to impact frontal lobe executive function networks; 2) Visuomotor adaptation, which may depend on the integrity of parietal and parieto- and subcortical-frontal connections and the presence of a particular subtype of neglect labeled Aiming neglect; 3) Non-invasive brain stimulation that may modulate relative levels of activity of the two hemispheres and depend on corpus callosum connectivity; and 4) Pharmacological modulation that may exert its effect primarily via right-lateralized networks more closely involved in arousal. EXPERT OPINION Despite promising results from individual studies, significant methodological heterogeneity between trials weakened conclusions drawn from meta-analyses. Improved classification of spatial neglect subtypes will benefit research and clinical care. Understanding the brain network mechanisms of different treatments and different types of spatial neglect will make possible a precision medicine treatment approach.
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Affiliation(s)
- Alex R. Carter
- Department of Neurology, Department of Orthopedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - A.M. Barrett
- UMass Chan Medical School and UMass Memorial Healthcare, Worcester, MA, USA
- Central Western MA VA Healthcare System, Worcester, MA, USA
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Yang YX, Wang LL, Du J, Luo YM, Xie YL, Zhang B, Zhang H. Prism adaptation combined with eye movement training for unilateral spatial neglect after stroke: Study protocol for a single-blind prospective, randomized controlled trial. Front Neurol 2023; 13:1081895. [PMID: 36686538 PMCID: PMC9849677 DOI: 10.3389/fneur.2022.1081895] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/06/2022] [Indexed: 01/06/2023] Open
Abstract
Background Unilateral spatial neglect (USN) is a complex neurological syndrome that often reduces rehabilitation outcomes, prolongs patients' hospital stays, and decreases their quality of life. However, the current therapies for USN have varying efficacy. We will explore a new treatment option that combines prism adaptation (PA) with eye movement training (EMT) for the treatment of USN after stroke. Methods We will conduct a single-blind, prospective, randomized controlled trial to assess the efficacy of the combined intervention (PA & EMT) on USN in an inpatient rehabilitation setting. The study aims to recruit 88 patients with USN after an ischemic or hemorrhagic stroke. Participants will be randomly assigned to the following four groups: (1) PA group (n = 22), (2) EMT group (n = 22), (3) PA and EMT group (n = 22), and (4) control group (n = 22). All groups will receive 10 sessions of interventions over 2 weeks, 5 times per week. Blinded assessors will conduct a baseline assessment, a post-intervention assessment, and a follow-up assessment (2 weeks post-intervention). The primary outcome measure will use the Behavioral Inattention Test-Conventional Subset (BIT-C) and Catherine Bergego Scale (CBS) to assess the levels of USN. Secondary outcome measures will assess the patient's ability to perform activities of daily living using the Modified Barthel Index (MBI). Patients who completed all treatment and assessment sessions will be included in the final analysis. Discussion This study will explore the effects of 10 sessions of combined interventions (PA & EMT) on USN and functional capacity. This study has the potential to identify a new, evidence-based treatment option and provide new ideas for the treatment of USN. Ethics and dissemination The study protocol has been approved by the Nanchong Central Hospital. Written informed consent will be obtained from all the participants. The results of this study will be disseminated to the public through scientific conferences and a peer-reviewed journal. Trial registration ChiCTR, ChiCTR2100049482. Registered on 2 August 2021, http://www.chictr.org.cn/showproj.aspx?proj=130823.
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Affiliation(s)
- Yu-xuan Yang
- Department of Rehabilitation Medicine, The Second Clinical Medical School of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Ling-ling Wang
- Department of Rehabilitation Medicine, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Juan Du
- Department of Rehabilitation Medicine, The Second Clinical Medical School of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Yao-min Luo
- Department of Rehabilitation Medicine, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yu-lei Xie
- School of Rehabilitation, China Rehabilitation Research Center, Capital Medical University, Beijing, China
| | - Bo Zhang
- Department of Rehabilitation Medicine, The Second Clinical Medical School of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China,*Correspondence: Bo Zhang ✉ :
| | - Han Zhang
- Department of Rehabilitation Medicine, The Second Clinical Medical School of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China,Han Zhang ✉
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Wilf M, Dupuis C, Nardo D, Huber D, Sander S, Al-Kaar J, Haroud M, Perrin H, Fornari E, Crottaz-Herbette S, Serino A. Virtual reality-based sensorimotor adaptation shapes subsequent spontaneous and naturalistic stimulus-driven brain activity. Cereb Cortex 2022; 33:5163-5180. [PMID: 36288926 PMCID: PMC10152055 DOI: 10.1093/cercor/bhac407] [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: 03/09/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/12/2022] Open
Abstract
Our everyday life summons numerous novel sensorimotor experiences, to which our brain needs to adapt in order to function properly. However, tracking plasticity of naturalistic behavior and associated brain modulations is challenging. Here, we tackled this question implementing a prism adaptation-like training in virtual reality (VRPA) in combination with functional neuroimaging. Three groups of healthy participants (N = 45) underwent VRPA (with a shift either to the left/right side, or with no shift), and performed functional magnetic resonance imaging (fMRI) sessions before and after training. To capture modulations in free-flowing, task-free brain activity, the fMRI sessions included resting-state and free-viewing of naturalistic videos. We found significant decreases in spontaneous functional connectivity between attentional and default mode (DMN)/fronto-parietal networks, only for the adaptation groups, more pronouncedly in the hemisphere contralateral to the induced shift. In addition, VRPA was found to bias visual responses to naturalistic videos: Following rightward adaptation, we found upregulation of visual response in an area in the parieto-occipital sulcus (POS) only in the right hemisphere. Notably, the extent of POS upregulation correlated with the size of the VRPA-induced after-effect measured in behavioral tests. This study demonstrates that a brief VRPA exposure can change large-scale cortical connectivity and correspondingly bias visual responses to naturalistic sensory inputs.
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Affiliation(s)
- Meytal Wilf
- MySpace Lab, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre Decker 5, 1011 Lausanne, Switzerland.,Center of Advanced Technologies in Rehabilitation (CATR), Sheba Medical Center, Tel Hashomer 52621, Israel
| | - Celine Dupuis
- MindMaze SA, Chemin de Roseneck 5, 1006 Lausanne, Switzerland
| | - Davide Nardo
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Rd, Cambridge CB2 7EF, United Kingdom.,Department of Education, University of Roma Tre, Rome, Italy
| | - Diana Huber
- MySpace Lab, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre Decker 5, 1011 Lausanne, Switzerland
| | - Sibilla Sander
- MySpace Lab, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre Decker 5, 1011 Lausanne, Switzerland
| | - Joud Al-Kaar
- Neuropsychology and Neurorehabilitation Service, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre Decker 5, 1011 Lausanne, Switzerland
| | - Meriem Haroud
- MySpace Lab, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre Decker 5, 1011 Lausanne, Switzerland.,Neuropsychology and Neurorehabilitation Service, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre Decker 5, 1011 Lausanne, Switzerland
| | - Henri Perrin
- MySpace Lab, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre Decker 5, 1011 Lausanne, Switzerland
| | - Eleonora Fornari
- Biomedical Imaging Center (CIBM), Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Sonia Crottaz-Herbette
- MindMaze SA, Chemin de Roseneck 5, 1006 Lausanne, Switzerland.,Neuropsychology and Neurorehabilitation Service, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre Decker 5, 1011 Lausanne, Switzerland
| | - Andrea Serino
- MySpace Lab, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre Decker 5, 1011 Lausanne, Switzerland.,MindMaze SA, Chemin de Roseneck 5, 1006 Lausanne, Switzerland
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Schintu S, Gotts SJ, Freedberg M, Shomstein S, Wassermann EM. Effective connectivity underlying neural and behavioral components of prism adaptation. Front Psychol 2022; 13:915260. [PMID: 36118425 PMCID: PMC9479732 DOI: 10.3389/fpsyg.2022.915260] [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: 04/08/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Prism adaptation (PA) is a form of visuomotor training that produces both sensorimotor and cognitive aftereffects depending on the direction of the visual displacement. Recently, a neural framework explaining both types of PA-induced aftereffects has been proposed, but direct evidence for it is lacking. We employed Structural Equation Modeling (SEM), a form of effective connectivity analysis, to establish directionality among connected nodes of the brain network thought to subserve PA. The findings reveal two distinct network branches: (1) a loop involving connections from the parietal cortices to the right parahippocampal gyrus, and (2) a branch linking the lateral premotor cortex to the parahippocampal gyrus via the cerebellum. Like the sensorimotor aftereffects, the first branch exhibited qualitatively different modulations for left versus right PA, and critically, changes in these connections were correlated with the magnitude of the sensorimotor aftereffects. Like the cognitive aftereffects, changes in the second branch were qualitatively similar for left and right PA, with greater change for left PA and a trend correlation with cognitive aftereffects. These results provide direct evidence that PA is supported by two functionally distinct subnetworks, a parietal–temporal network responsible for sensorimotor aftereffects and a fronto-cerebellar network responsible for cognitive aftereffects.
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Affiliation(s)
- Selene Schintu
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, United States
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Trentino, Italy
- *Correspondence: Selene Schintu,
| | - Stephen J. Gotts
- Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD, United States
| | - Michael Freedberg
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, United States
| | - Sarah Shomstein
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, United States
| | - Eric M. Wassermann
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States
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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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Clarke S, Farron N, Crottaz-Herbette S. Choosing Sides: Impact of Prismatic Adaptation on the Lateralization of the Attentional System. Front Psychol 2022; 13:909686. [PMID: 35814089 PMCID: PMC9260393 DOI: 10.3389/fpsyg.2022.909686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Seminal studies revealed differences between the effect of adaptation to left- vs. right-deviating prisms (L-PA, R-PA) in normal subjects. Whereas L-PA leads to neglect-like shift in attention, demonstrated in numerous visuo-spatial and cognitive tasks, R-PA has only minor effects in specific aspects of a few tasks. The paucity of R-PA effects in normal subjects contrasts with the striking alleviation of neglect symptoms in patients with right hemispheric lesions. Current evidence from activation studies in normal subjects highlights the contribution of regions involved in visuo-motor control during prism exposure and a reorganization of spatial representations within the ventral attentional network (VAN) after the adaptation. The latter depends on the orientation of prisms used. R-PA leads to enhancement of the ipsilateral visual and auditory space within the left inferior parietal lobule (IPL), switching thus the dominance of VAN from the right to the left hemisphere. L-PA leads to enhancement of the ipsilateral space in right IPL, emphasizing thus the right hemispheric dominance of VAN. Similar reshaping has been demonstrated in patients. We propose here a model, which offers a parsimonious explanation of the effect of L-PA and R-PA both in normal subjects and in patients with hemispheric lesions. The model posits that prismatic adaptation induces instability in the synaptic organization of the visuo-motor system, which spreads to the VAN. The effect is lateralized, depending on the side of prism deviation. Successful pointing with prisms implies reaching into the space contralateral, and not ipsilateral, to the direction of prism deviation. Thus, in the hemisphere contralateral to prism deviation, reach-related neural activity decreases, leading to instability of the synaptic organization, which induces a reshuffling of spatial representations in IPL. Although reshuffled spatial representations in IPL may be functionally relevant, they are most likely less efficient than regular representations and may thus cause partial dysfunction. The former explains, e.g., the alleviation of neglect symptoms after R-PA in patients with right hemispheric lesions, the latter the occurrence of neglect-like symptoms in normal subjects after L-PA. Thus, opting for R- vs. L-PA means choosing the side of major IPL reshuffling, which leads to its partial dysfunction in normal subjects and to recruitment of alternative or enhanced spatial representations in patients with hemispheric lesions.
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Feasibility study of immersive virtual prism adaptation therapy with depth-sensing camera using functional near-infrared spectroscopy in healthy adults. Sci Rep 2022; 12:767. [PMID: 35031675 PMCID: PMC8760318 DOI: 10.1038/s41598-022-04771-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 12/22/2021] [Indexed: 11/08/2022] Open
Abstract
Prism Adaptation (PA) is used to alleviate spatial neglect. We combined immersive virtual reality with a depth-sensing camera to develop virtual prism adaptation therapy (VPAT), which block external visual cues and easily quantify and monitor errors than conventional PA. We conducted a feasibility study to investigate whether VPAT can induce behavioral adaptations by measuring after-effect and identifying which cortical areas were most significantly activated during VPAT using functional near-infrared spectroscopy (fNIRS). Fourteen healthy subjects participated in this study. The experiment consisted of four sequential phases (pre-VPAT, VPAT-10°, VPAT-20°, and post-VPAT). To compare the most significantly activated cortical areas during pointing in different phases against pointing during the pre-VPAT phase, we analyzed changes in oxyhemoglobin concentration using fNIRS during pointing. The pointing errors of the virtual hand deviated to the right-side during early pointing blocks in the VPAT-10° and VPAT-20° phases. There was a left-side deviation of the real hand to the target in the post-VPAT phase, demonstrating after-effect. The most significantly activated channels during pointing tasks were located in the right hemisphere, and possible corresponding cortical areas included the dorsolateral prefrontal cortex and frontal eye field. In conclusion, VPAT may induce behavioral adaptation with modulation of the dorsal attentional network.
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Facchin A, Figliano G, Daini R. Prism Adaptation and Optokinetic Stimulation Comparison in the Rehabilitation of Unilateral Spatial Neglect. Brain Sci 2021; 11:brainsci11111488. [PMID: 34827487 PMCID: PMC8615435 DOI: 10.3390/brainsci11111488] [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: 10/04/2021] [Revised: 11/05/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Prism adaptation (PA) is one of the most effective treatments for the rehabilitation of unilateral spatial neglect. Optokinetic stimulation (OKS) has also been demonstrated to be effective in ameliorating symptoms of neglect. The aim of this study is to compare the effectiveness of these two methods in a group of neglect patients using a crossover design. A group of 13 post-acute brain-damaged patients with unilateral spatial neglect, who had never been rehabilitated, were treated using PA and OKS. Each treatment was applied for 10 sessions, twice a day, to all patients with both treatments in crossed order (i.e., PA followed by OKS or vice versa). Neuropsychological assessments were performed: before the first (T1), at the end of the first/beginning of the second (T2) and at the end of the second training sessions (T3), and two weeks after the end of treatment (T4). Both procedures produced a significant improvement in clinical tests at T2, independent of the type of training. The results suggest that either PA or OKS induces a significant amelioration of neglect in right brain-damaged patients, mainly in the first block of treatment. Since no differences between treatments were found, they could be applied in clinical practice, according to the requirements of the individual patient.
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Affiliation(s)
- Alessio Facchin
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (G.F.); (R.D.)
- COMiB—Optics and Optometry Research Center, Università Degli Studi di Milano-Bicocca & NeuroMI—Milan Center for Neuroscience, 20126 Milan, Italy
- Correspondence:
| | - Giusi Figliano
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (G.F.); (R.D.)
| | - Roberta Daini
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (G.F.); (R.D.)
- COMiB—Optics and Optometry Research Center, Università Degli Studi di Milano-Bicocca & NeuroMI—Milan Center for Neuroscience, 20126 Milan, Italy
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Boukrina O, Chen P. Neural Mechanisms of Prism Adaptation in Healthy Adults and Individuals with Spatial Neglect after Unilateral Stroke: A Review of fMRI Studies. Brain Sci 2021; 11:1468. [PMID: 34827467 PMCID: PMC8615640 DOI: 10.3390/brainsci11111468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 12/24/2022] Open
Abstract
Functional disability due to spatial neglect hinders recovery in up to 30% of stroke survivors. Prism adaptation treatment (PAT) may alleviate the disabling consequences of spatial neglect, but we do not yet know why some individuals show much better outcomes following PAT than others. The goal of this scoping review and meta-analysis was to investigate the neural mechanisms underlying prism adaptation (PA). We conducted both quantitative and qualitative analyses across fMRI studies investigating brain activity before, during, and after PA, in healthy individuals and patients with right or left brain damage (RBD or LBD) due to stroke. In healthy adults, PA was linked with activity in posterior parietal and cerebellar clusters, reduced bilateral parieto-frontal connectivity, and increased fronto-limbic and sensorimotor network connectivity. In contrast, RBD individuals with spatial neglect relied on different circuits, including an activity cluster in the intact left occipital cortex. This finding is consistent with a shift in hemispheric dominance in spatial processing to the left hemisphere. However, more studies are needed to clarify the contribution of lesion location and load on the circuits involved in PA after unilateral brain damage. Future studies are also needed to clarify the relationship of decreasing resting state functional connectivity (rsFC) to visuomotor function.
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Affiliation(s)
- Olga Boukrina
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ 07052, USA;
- Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ 07103, USA
| | - Peii Chen
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ 07052, USA;
- Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ 07103, USA
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14
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Abstract
During prism adaptation (PA), active exposure to an optical shift results in sustained modifications of the sensorimotor system, which have been shown to expand to the cognitive level and serve as a rehabilitation technique for spatial cognition disorders. Several models based on evidence from clinical and neuroimaging studies offered a description of the cognitive and the neural correlates of PA. However, recent findings using noninvasive neurostimulation call for a reexamination of the role of the primary motor cortex (M1) in PA. Specifically, recent studies demonstrated that M1 stimulation reactivates previously vanished sensorimotor changes 1 day after PA, induces after-effect strengthening, and boosts therapeutic effects up to the point of reversing treatment-resistant unilateral neglect. Here, we articulate findings from clinical, neuroimaging, and noninvasive brain stimulation studies to show that M1 contributes to acquiring and storing PA, by means of persisting latent changes after the behavioral training is terminated, consistent with studies on other sensorimotor adaptation procedures. Moreover, we describe the hierarchical organization as well as the timing of PA mechanisms and their anatomical correlates, and identify M1 as an anatomo-functional interface between low- and high-order PA-related mechanisms.
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Affiliation(s)
| | - Lisa Fleury
- Hospices Civils de Lyon, France.,Trajectoires, Centre de Recherche en Neurosciences de Lyon, Bron, France
| | - Luigi Trojano
- University of Campania "Luigi Vanvitelli," Caserta, Italy
| | - Yves Rossetti
- Hospices Civils de Lyon, France.,Trajectoires, Centre de Recherche en Neurosciences de Lyon, Bron, France
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15
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Zhang Y, Hua Y, Bai Y. Applications of Functional Magnetic Resonance Imaging in Determining the Pathophysiological Mechanisms and Rehabilitation of Spatial Neglect. Front Neurol 2020; 11:548568. [PMID: 33281698 PMCID: PMC7688780 DOI: 10.3389/fneur.2020.548568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 09/25/2020] [Indexed: 12/16/2022] Open
Abstract
Functional magnetic resonance imaging (fMRI) is a neuroimaging tool which has been applied extensively to explore the pathophysiological mechanisms of neurological disorders. Spatial neglect is considered to be the failure to attend or respond to stimuli on the side of the space or body opposite a cerebral lesion. In this review, we summarize and analyze fMRI studies focused specifically on spatial neglect. Evidence from fMRI studies have highlighted the role of dorsal and ventral attention networks in the pathophysiological mechanisms of spatial neglect, and also support the concept of interhemispheric rivalry as an explanatory model. fMRI studies have shown that several rehabilitation methods can induce activity changes in brain regions implicated in the control of spatial attention. Future investigations with large study cohorts and appropriate subgroup analyses should be conducted to confirm the possibility that fMRI might offer an objective standard for predicting spatial neglect and tracking the response of brain activity to clinical treatment, as well as provide biomarkers to guide rehabilitation for patients with SN.
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Affiliation(s)
- Yuqian Zhang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan Hua
- Department of Rehabilitation Medicine, Huashan Hospital North, Fudan University, Shanghai, China
| | - Yulong Bai
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
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16
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Combined virtual reality and haptic robotics induce space and movement invariant sensorimotor adaptation. Neuropsychologia 2020; 150:107692. [PMID: 33232695 DOI: 10.1016/j.neuropsychologia.2020.107692] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 10/12/2020] [Accepted: 11/13/2020] [Indexed: 11/22/2022]
Abstract
Prism adaptation is a method for studying visuomotor plasticity in healthy individuals, as well as for rehabilitating patients suffering spatial neglect. We developed a new set-up based on virtual-reality (VR) and haptic-robotics allowing us to induce sensorimotor adaptation and to reproduce the effect of prism adaptation in a more ecologically valid, yet experimentally controlled context. Participants were exposed to an immersive VR environment while controlling a virtual hand via a robotic-haptic device to reach virtual objects. During training, a rotational shift was induced between the position of the participant's real hand and that of the virtual hand in order to trigger sensorimotor recalibration. The use of VR and haptic-robotics allowed us to simulate and test multiple components of sensorimotor adaptation: training either peripersonal or extrapersonal space and testing generalization for the non-trained sector of space, and using active versus robot-guided reaching movements. Results from 60 neurologically intact participants show that participants exposed to the virtual shift were able to quickly adapt their reaching movements to aim correctly at the target objects. When the shift was removed, participants showed a systematic deviation of their movements during open-loop tasks in the direction opposite to that of the shift, which generalized to un-trained portions of space and occurred also when their movements were robotically-guided during the adaptation. Interestingly, follow-up questionnaires revealed that when the adaptation training was robotically-guided, participants were largely unaware of the mismatch between their hand and the virtual hand's position. The stability of the aftereffects, despite the changing experimental parameters, suggests that the induced sensory-motor adaptation does not rely on low-level processing of sensory stimuli during the training, but taps into high-level representations of space. Importantly, the flexibility of the trained space and the option of robotically-guided movements open novel possibilities of fine-tuning the training to patients' level of spatial and motor impairment, thus possibly resulting in a better outcome.
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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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18
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Gudmundsson L, Vohryzek J, Fornari E, Clarke S, Hagmann P, Crottaz-Herbette S. A brief exposure to rightward prismatic adaptation changes resting-state network characteristics of the ventral attentional system. PLoS One 2020; 15:e0234382. [PMID: 32584824 PMCID: PMC7316264 DOI: 10.1371/journal.pone.0234382] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 05/26/2020] [Indexed: 12/02/2022] Open
Abstract
A brief session of rightward prismatic adaptation (R-PA) has been shown to alleviate neglect symptoms in patients with right hemispheric damage, very likely by switching hemispheric dominance of the ventral attentional network (VAN) from the right to the left and by changing task-related activity within the dorsal attentional network (DAN). We have investigated this very rapid change in functional organisation with a network approach by comparing resting-state connectivity before and after a brief exposure i) to R-PA (14 normal subjects; experimental condition) or ii) to plain glasses (12 normal subjects; control condition). A whole brain analysis (comprising 129 regions of interest) highlighted R-PA-induced changes within a bilateral, fronto-temporal network, which consisted of 13 nodes and 11 edges; all edges involved one of 4 frontal nodes, which were part of VAN. The analysis of network characteristics within VAN and DAN revealed a R-PA-induced decrease in connectivity strength between nodes and a decrease in local efficiency within VAN but not within DAN. These results indicate that the resting-state connectivity configuration of VAN is modulated by R-PA, possibly by decreasing its modularity.
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Affiliation(s)
- Louis Gudmundsson
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
- Neuropsychology and Neurorehabilitation Service, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
| | - Jakub Vohryzek
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
- Department of Psychiatry, Hedonia Research Group, University of Oxford, Oxford, United Kingdom
| | - Eleonora Fornari
- CIBM (Centre d'Imagerie Biomédicale), Dept. of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
| | - Stephanie Clarke
- Neuropsychology and Neurorehabilitation Service, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
| | - Patric Hagmann
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
- Signal Processing Lab 5 (LTS5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Sonia Crottaz-Herbette
- Neuropsychology and Neurorehabilitation Service, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
- * E-mail:
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19
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Schintu S, Freedberg M, Gotts SJ, Cunningham CA, Alam ZM, Shomstein S, Wassermann EM. Prism Adaptation Modulates Connectivity of the Intraparietal Sulcus with Multiple Brain Networks. Cereb Cortex 2020; 30:4747-4758. [PMID: 32313949 DOI: 10.1093/cercor/bhaa032] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 01/16/2020] [Accepted: 01/30/2020] [Indexed: 12/19/2022] Open
Abstract
Prism adaptation (PA) alters spatial cognition according to the direction of visual displacement by temporarily modifying sensorimotor mapping. Right-shifting prisms (right PA) improve neglect of left visual field in patients, possibly by decreasing activity in the left hemisphere and increasing it in the right. Left PA shifts attention rightward in healthy individuals by an opposite mechanism. However, functional imaging studies of PA are inconsistent, perhaps because of differing activation tasks. We measured resting-state functional connectivity (RSFC) in healthy individuals before and after PA. When contrasted, right versus left PA decreased RSFC in the spatial navigation network defined by the right posterior parietal cortex (PPC), hippocampus, and cerebellum. Within-PA-direction comparisons showed that right PA increased RSFC in subregions of the PPCs and between the PPCs and the right middle frontal gyrus and left PA decreased RSFC between these regions. Both right and left PA decreased RSFC between the PPCs and bilateral temporal areas. In summary, right PA increases connectivity in the right frontoparietal network and left PA produces essentially opposite effects. Furthermore, right, compared with left, PA modulates RSFC in the right hemisphere navigation network.
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Affiliation(s)
- Selene Schintu
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke Bethesda, MD 20892, USA.,Department of Psychology George Washington University Washington, DC 20052, USA
| | - Michael Freedberg
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke Bethesda, MD 20892, USA
| | - Stephen J Gotts
- Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD 20892, USA
| | - Catherine A Cunningham
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke Bethesda, MD 20892, USA
| | - Zaynah M Alam
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke Bethesda, MD 20892, USA
| | - Sarah Shomstein
- Department of Psychology George Washington University Washington, DC 20052, USA
| | - Eric M Wassermann
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke Bethesda, MD 20892, USA
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20
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On the mechanisms underlying Prism Adaptation: A review of neuro-imaging and neuro-stimulation studies. Cortex 2020; 123:57-71. [DOI: 10.1016/j.cortex.2019.10.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/19/2019] [Accepted: 10/16/2019] [Indexed: 01/09/2023]
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21
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Goedert KM, Chen P, Foundas AL, Barrett A. Frontal lesions predict response to prism adaptation treatment in spatial neglect: A randomised controlled study. Neuropsychol Rehabil 2020; 30:32-53. [PMID: 29558241 PMCID: PMC6148387 DOI: 10.1080/09602011.2018.1448287] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 02/28/2018] [Indexed: 10/17/2022]
Abstract
Spatial neglect commonly follows right hemisphere stroke. It is defined as impaired contralesional stimulus detection, response, or action, causing functional disability. While prism adaptation treatment is highly promising to promote functional recovery of spatial neglect, not all individuals respond. Consistent with a primary effect of prism adaptation on spatial movements, we previously demonstrated that functional improvement after prism adaptation treatment is linked to frontal lobe lesions. However, that study was a treatment-only study with no randomised control group. The current study randomised individuals with spatial neglect to receive 10 days of prism adaptation treatment or to receive only standard care (control group). Replicating our earlier results, we found that the presence of frontal lesions moderated response to prism adaptation treatment: among prism-treated patients, only those with frontal lesions demonstrated functional improvements in their neglect symptoms. Conversely, among individuals in the standard care control group, the presence of frontal lesions did not modify recovery. These results suggest that further research is needed on how frontal lesions may predict response to prism adaptation treatment. Additionally, the results help elucidate the neural network involved in spatial movement and could be used to aid decisions about treatment.
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Affiliation(s)
- Kelly M. Goedert
- Department of Psychology, Seton Hall University, 400 South Orange Ave., South Orange, NJ 07079, phone: 1-973-275-2703;
| | - Peii Chen
- Stroke Rehabilitation Research, Kessler Foundation, Department of Physical Medicine and Rehabilitation, Rutgers- New Jersey Medical School, 1199 Pleasant Valley Way, West Orange, NJ 07052, phone: 1-973-324-2574;
| | - Anne L. Foundas
- Department of Psychology, Tulane University, 2007 Percival Stern Hall, New Orleans, Louisiana 70118, phone: (504) 865-5331,
| | - A.M. Barrett
- Stroke Rehabilitation Research, Kessler Foundation, Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Kessler Institute for Rehabilitation, 1199 Pleasant Valley Way, West Orange, NJ 07052, phone: 1-973-324-3569;
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Saj A, Cojan Y, Assal F, Vuilleumier P. Prism adaptation effect on neural activity and spatial neglect depend on brain lesion site. Cortex 2019; 119:301-311. [DOI: 10.1016/j.cortex.2019.04.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 01/07/2019] [Accepted: 04/29/2019] [Indexed: 11/27/2022]
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23
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Crottaz-Herbette S, Tissieres I, Fornari E, Rapin PA, Clarke S. Remodelling the attentional system after left hemispheric stroke: Effect of leftward prismatic adaptation. Cortex 2019; 115:43-55. [DOI: 10.1016/j.cortex.2019.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 10/30/2018] [Accepted: 01/08/2019] [Indexed: 10/27/2022]
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25
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Schintu S, Freedberg M, Alam ZM, Shomstein S, Wassermann EM. Left-shifting prism adaptation boosts reward-based learning. Cortex 2018; 109:279-286. [PMID: 30399479 PMCID: PMC7327780 DOI: 10.1016/j.cortex.2018.09.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/08/2018] [Accepted: 09/21/2018] [Indexed: 01/08/2023]
Abstract
Visuospatial cognition has an inherent lateralized bias. Individual differences in the direction and magnitude of this bias are associated with asymmetrical D2/3 dopamine binding and dopamine system genotypes. Dopamine level affects feedback-based learning and dopamine signaling asymmetry is related to differential learning from reward and punishment. High D2 binding in the left hemisphere is associated with preference for reward. Prism adaptation (PA) is a simple sensorimotor technique, which modulates visuospatial bias according to the direction of the deviation. Left-deviating prism adaptation (LPA) induces rightward bias in healthy subjects. It is therefore possible that the right side of space increases in saliency along with left hemisphere dopaminergic activity. Right-deviating prism adaptation (RPA) has been used mainly as a control condition because it does not modulate behavior in healthy individuals. Since LPA induces a rightward visuospatial bias as a result of left hemisphere modulation, and higher dopaminergic activity in the left hemisphere is associated with preference for rewarding events we hypothesized that LPA would increase the preference for learning with reward. Healthy volunteers performed a computer-based probabilistic classification task before and after LPA or RPA. Consistent with our predictions, PA altered the preference for rewarded versus punished learning, with the LPA group exhibiting increased learning from reward. These results suggest that PA modulates dopaminergic activity in a lateralized fashion.
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Affiliation(s)
- Selene Schintu
- Behavioral Neurology Unit, National Institute for Neurological Disorders and Stroke, Bethesda, USA; Department of Psychology, George Washington University, Washington, USA.
| | - Michael Freedberg
- Behavioral Neurology Unit, National Institute for Neurological Disorders and Stroke, Bethesda, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, USA
| | - Zaynah M Alam
- Behavioral Neurology Unit, National Institute for Neurological Disorders and Stroke, Bethesda, USA
| | - Sarah Shomstein
- Department of Psychology, George Washington University, Washington, USA
| | - Eric M Wassermann
- Behavioral Neurology Unit, National Institute for Neurological Disorders and Stroke, Bethesda, USA
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Tissieres I, Fornari E, Clarke S, Crottaz-Herbette S. Supramodal effect of rightward prismatic adaptation on spatial representations within the ventral attentional system. Brain Struct Funct 2017; 223:1459-1471. [PMID: 29151115 DOI: 10.1007/s00429-017-1572-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 11/15/2017] [Indexed: 10/18/2022]
Abstract
Rightward prismatic adaptation (R-PA) was shown to alleviate not only visuo-spatial but also auditory symptoms in neglect. The neural mechanisms underlying the effect of R-PA have been previously investigated in visual tasks, demonstrating a shift of hemispheric dominance for visuo-spatial attention from the right to the left hemisphere both in normal subjects and in patients. We have investigated whether the same neural mechanisms underlie the supramodal effect of R-PA on auditory attention. Normal subjects underwent a brief session of R-PA, which was preceded and followed by an fMRI evaluation during which subjects detected targets within the left, central and right space in the auditory or visual modality. R-PA-related changes in activation patterns were found bilaterally in the inferior parietal lobule. In either modality, the representation of the left, central and right space increased in the left IPL, whereas the representation of the right space decreased in the right IPL. Thus, a brief exposure to R-PA modulated the representation of the auditory and visual space within the ventral attentional system. This shift in hemispheric dominance for auditory spatial attention offers a parsimonious explanation for the previously reported effects of R-PA on auditory symptoms in neglect.
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Affiliation(s)
- Isabel Tissieres
- Neuropsychology and Neurorehabilitation Service, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Av. Pierre-Decker 5, 1011, Lausanne, Switzerland
| | - Eleonora Fornari
- CIBM (Centre d'Imagerie Biomédicale), Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, 1011, Lausanne, Switzerland
| | - Stephanie Clarke
- Neuropsychology and Neurorehabilitation Service, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Av. Pierre-Decker 5, 1011, Lausanne, Switzerland
| | - Sonia Crottaz-Herbette
- Neuropsychology and Neurorehabilitation Service, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Av. Pierre-Decker 5, 1011, Lausanne, Switzerland.
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27
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For Better or Worse: The Effect of Prismatic Adaptation on Auditory Neglect. Neural Plast 2017; 2017:8721240. [PMID: 29138699 PMCID: PMC5613466 DOI: 10.1155/2017/8721240] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 08/08/2017] [Indexed: 12/01/2022] Open
Abstract
Patients with auditory neglect attend less to auditory stimuli on their left and/or make systematic directional errors when indicating sound positions. Rightward prismatic adaptation (R-PA) was repeatedly shown to alleviate symptoms of visuospatial neglect and once to restore partially spatial bias in dichotic listening. It is currently unknown whether R-PA affects only this ear-related symptom or also other aspects of auditory neglect. We have investigated the effect of R-PA on left ear extinction in dichotic listening, space-related inattention assessed by diotic listening, and directional errors in auditory localization in patients with auditory neglect. The most striking effect of R-PA was the alleviation of left ear extinction in dichotic listening, which occurred in half of the patients with initial deficit. In contrast to nonresponders, their lesions spared the right dorsal attentional system and posterior temporal cortex. The beneficial effect of R-PA on an ear-related performance contrasted with detrimental effects on diotic listening and auditory localization. The former can be parsimoniously explained by the SHD-VAS model (shift in hemispheric dominance within the ventral attentional system; Clarke and Crottaz-Herbette 2016), which is based on the R-PA-induced shift of the right-dominant ventral attentional system to the left hemisphere. The negative effects in space-related tasks may be due to the complex nature of auditory space encoding at a cortical level.
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