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Besharati S, Jenkinson PM, Kopelman M, Solms M, Bulgarelli C, Pacella V, Moro V, Fotopoulou A. What I think she thinks about my paralysed body: Social inferences about disability-related content in anosognosia for hemiplegia. J Neuropsychol 2024. [PMID: 38899773 DOI: 10.1111/jnp.12378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/06/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024]
Abstract
The neuropsychological disorder of anosognosia for hemiplegia (AHP) can offer unique insights into the neurocognitive processes of body consciousness and representation. Previous studies have found associations between selective social cognition deficits and anosognosia. In this study, we examined how such social cognition deficits may directly interact with representations of one's body as disabled in AHP. We used a modified set of previously validated Theory of Mind (ToM) stories to create disability-related content that was related to post-stroke paralysis and to investigate differences between right hemisphere damage patients with (n = 19) and without (n = 19) AHP. We expected AHP patients to perform worse than controls when trying to infer paralysis-related mental states in the paralysis-related ToM stories and explored whether such differences depended on the inference patients were asked to perform (e.g. self or other referent perspective-taking). Using an advanced structural neuroimaging technique, we expected selective social cognitive deficits to be associated with posterior parietal cortex lesions and deficits in self-referent perspective-taking in paralysis-related mentalising to be associated with frontoparietal disconnections. Group- and individual-level results revealed that AHP patients performed worse than HP controls when trying to infer paralysis-related mental states. Exploratory lesion analysis results revealed some of the hypothesised lesions, but also unexpected white matter disconnections in the posterior body and splenium of the corpus collosum associated with a self-referent perspective-taking in paralysis-related ToM stories. The study has implications for the multi-layered nature of body awareness, including abstract, social perspectives and beliefs about the body.
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Affiliation(s)
- Sahba Besharati
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Paul M Jenkinson
- Faculty of Psychology, Counselling and Psychotherapy, The Cairnmillar Institute, Melbourne, Australia
- Research Department of Clinical, Educational and Heath Psychology, University College London, London, UK
| | - Michael Kopelman
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mark Solms
- Neuroscience Institute, University of Cape Town, Rondebosch, South Africa
| | | | | | - Valentina Moro
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Verona, Italy
| | - Aikaterini Fotopoulou
- Research Department of Clinical, Educational and Heath Psychology, University College London, London, UK
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Terruzzi S, Albini F, Massetti G, Etzi R, Gallace A, Vallar G. The Neuropsychological Assessment of Unilateral Spatial Neglect Through Computerized and Virtual Reality Tools: A Scoping Review. Neuropsychol Rev 2024; 34:363-401. [PMID: 36913099 PMCID: PMC10009867 DOI: 10.1007/s11065-023-09586-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 09/28/2022] [Indexed: 03/14/2023]
Abstract
Unilateral Spatial Neglect is a disabling neuropsychological deficit. Patients with spatial neglect fail to detect and report events, and to perform actions in the side of space contralateral to a hemispheric cerebral lesion. Neglect is assessed by evaluating the patients' abilities in daily life activities and by psychometric tests. Computer-based, portable and Virtual Reality technologies may provide more and precise data, and be more sensitive and informative, compared to current paper-and-pencil procedures. Studies since 2010, in which such technologies have been used, are reviewed. Forty-two articles meeting inclusion criteria are categorized according to their technological approaches (computer-, graphics tablet or tablet-, virtual reality-based assessment, and other). The results are promising. However, a definite golden standard, technologically based procedure cannot be still established. Developing technologically based tests is a laborious process, which requires technical and user experience improvements as well as normative data, to increase the evidence of efficacy for clinical evaluation of at least some of the tests considered in this review.
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Affiliation(s)
- Stefano Terruzzi
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy.
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy.
- Neurocognitive Rehabilitation Center (CeRiN), University of Trento, Rovereto, Italy.
| | - Federica Albini
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Gemma Massetti
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Roberta Etzi
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Alberto Gallace
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Vallar
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy.
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy.
- Neuropsychological Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Auxologico Italiano, Milan, Italy.
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3
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Moro V, Scandola M, Gobbetto V, Bertagnoli S, Beccherle M, Besharati S, Ponzo S, Fotopoulou A, Jenkinson PM. Examining the role of self-reported somatosensory sensations in body (dis)ownership: A scoping review and empirical study of patients with a disturbed sense of limb ownership. Neuropsychologia 2024; 194:108776. [PMID: 38141962 DOI: 10.1016/j.neuropsychologia.2023.108776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 12/25/2023]
Abstract
Patients with a disturbed sense of limb ownership (DSO) offer a unique window of insight into the multisensory processes contributing to the sense of body ownership. A limited amount of past research has examined the role of sensory deficits in DSO, and even less is known regarding the role of patient self-reported somatosensory sensations in the pathogenesis of DSO. To address this lack of knowledge we first conducted a systematic scoping review following PRISMA-SR guidelines, examining current research into somatosensory deficits and patient self-reported somatosensory sensations in patients with DSO. Eighty studies, including 277 DSO patients, were identified. The assessment of sensory deficits was generally limited in scope and quality, and deficits in tactile sensitivity and proprioception were most frequently found. The reporting of somatosensory sensations was even less frequent, with instances of paraesthesia (pins-and-needles), stiffness/rigidity, numbness and warmth, coldness and heaviness amongst the deficits recorded. In a second part of the study, we sought to directly address the lack of evidence concerning the impact of patient self-reported somatosensory sensations in DSO by measuring DSO and self-reported somatosensory sensations in a large (n = 121) sample of right-hemisphere stroke patients including N = 65 with DSO and N = 56 hemiplegic controls. Results show that feelings of coldness and stiffness modulate DSO symptoms. Sense of heaviness and numbness are more frequent in patients with DSO but do not have a clear impact on disownership symptomology. Although preliminary, these results suggest a role of subjective sensations about the felt body in the sense of limb ownership.
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Affiliation(s)
- Valentina Moro
- Npsy-Lab.Vr, Department of Human Sciences, University of Verona, Italy.
| | - Michele Scandola
- Npsy-Lab.Vr, Department of Human Sciences, University of Verona, Italy
| | | | - Sara Bertagnoli
- Social and Cognitive Neuroscience Laboratory, Department of Psychology, University La Sapienza, Roma, Italy
| | | | - Sahba Besharati
- Department of Psychology, University of Witwatersrand, Johannesburg, South Africa
| | | | - Aikaterini Fotopoulou
- Research Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Paul M Jenkinson
- Research Department of Clinical, Educational and Health Psychology, University College London, UK; ISN Psychology, Institute for Social Neuroscience, Melbourne, Australia.
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Beccherle M, Gobbetto V, Bertagnoli S, Bulgarelli C, Rossato E, Moro V. Illusory hand movements in the absence of asomatognosia, spatial neglect and anosognosia for hemiplegia. Cortex 2023; 168:176-180. [PMID: 37741133 DOI: 10.1016/j.cortex.2023.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/25/2023]
Affiliation(s)
| | | | - Sara Bertagnoli
- Social and Cognitive Neuroscience Laboratory, Department of Psychology, University La Sapienza, Roma, Italy
| | | | - Elena Rossato
- IRCSS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Valentina Moro
- Npsy-Lab.Vr, Department of Human Sciences, University of Verona, Italy.
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Serrada I, Williams L, Hordacre B, Hillier S. Key constructs of body awareness impairments post-stroke: a scoping review of assessment tools and interventions. Disabil Rehabil 2023; 45:3177-3198. [PMID: 36189909 DOI: 10.1080/09638288.2022.2123053] [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: 07/28/2021] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To summarise body awareness assessment tools and interventions relevant for stroke rehabilitation using a framework that categorises key body awareness constructs, disorders and impairments. MATERIALS AND METHODS Online electronic databases and trial registries were searched from inception until July 2021, in addition to hand searching reference lists of included studies and reviews. Study selection included any study design where the investigation involved assessing and/or intervening in body awareness following stroke. Data were extracted based on predefined criteria by two independent reviewers and mapped to the emergent framework. RESULTS The final analysis included 144 papers that reported 43 assessment tools and 8 types of interventions for body awareness. Consensus was reached on a synthesised body awareness framework. This comprised specific impairments and disorders, constructs, sub-categories and main categories leading to the overarching term of body awareness. Clinical and psychometric properties of the assessment tools were not reported or poorly evaluated, and the interventions lacked robust study designs and rigorous methods. CONCLUSIONS The framework produced will enable future research and clinical practice to be based on consistent concepts and definitions. Clinicians can also use this information to cautiously select assessment tools and/or interventions but are reminded of the limitations identified in this review.Implications for rehabilitationThere is limited understanding, compounded by inconsistent terminology and definitions regarding body awareness after stroke.A synthesized framework to define key constructs and definitions of body awareness is proposed.Assessment tools and interventions reported in the literature are mapped to the proposed framework.Psychometric properties of available tools are reported.Significant work remains to refine concepts of body awareness, develop and evaluate assessment tools and interventions.
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Affiliation(s)
- Ines Serrada
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, City East Campus, Adelaide, SA, Australia
| | - Lindy Williams
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, City East Campus, Adelaide, SA, Australia
| | - Brenton Hordacre
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, City East Campus, Adelaide, SA, Australia
| | - Susan Hillier
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, City East Campus, Adelaide, SA, Australia
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Mora L, Gonzalez Alted C, Cocchini G. The flubbed body: Pathological body size representation in personal neglect. Neuropsychologia 2023; 183:108522. [PMID: 36863608 DOI: 10.1016/j.neuropsychologia.2023.108522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/21/2023] [Accepted: 02/20/2023] [Indexed: 03/04/2023]
Abstract
Personal Neglect (PN) is a disorder in which patients fail to attend or explore the contralateral side of their body. An increasing number of studies have considered PN as a form of body representation disorder frequently observed following damage to parietal areas. The extent and the direction of the body misrepresentation is still unclear with recent studies suggesting a general reduction of contralesional hand size. However, little is known about the specificity of this representation and whether the misrepresentation also generalises to other body parts. We explored the features of the representation of the hands and face in a group of 9 right brain damaged patients with (PN+) and without PN (PN-), when compared to a healthy control group. For this, we used a body size estimation task with pictures, in which patients were required to choose the one that most closely matched the perceived size of their body part. We found that PN + patients showed a labile body representation for both hands and face, having a larger distorted representational range. Interestingly, in comparison with PN + patients and healthy controls, PN- patients also showed misrepresentation of the left contralesional hand which could be related to impaired motor performance of their upper limb. Our findings are discussed within a theoretical framework suggesting a reliance on multisensory integration (body representation, ownership, and motor influences) for an ordered representation of the size of the body.
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Affiliation(s)
- Laura Mora
- Goldsmiths University of London, London, UK.
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Lafitte R, Jeager M, Piscicelli C, Dai S, Lemaire C, Chrispin A, Davoine P, Dupierrix E, Pérennou D. Spatial neglect encompasses impaired verticality representation after right hemisphere stroke. Ann N Y Acad Sci 2023; 1520:140-152. [PMID: 36478572 DOI: 10.1111/nyas.14938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Spatial neglect after right hemisphere stroke (RHS) was recently found to encompass lateropulsion, a deficit in body orientation with respect to gravity caused by altered brain processing of graviception. By analogy, we hypothesized that spatial neglect after RHS might encompass an altered representation of verticality. We also assumed a strong relation between body neglect and impaired postural vertical, both referring to the body. To tackle these issues, we performed contingency and correlation analyses between two domains of spatial neglect (body, extra-body) and two modalities of verticality perception (postural, visual) in 77 individuals (median age = 67) with a first-ever subacute RHS (1-3 months). All individuals with a transmodal (postural and visual) tilt in verticality perception (n = 26) had spatial neglect, but the reverse was not found. Correlation and multivariate analyses revealed that spatial neglect (and notably body neglect) was associated more with postural than visual vertical tilts. These findings indicate that after RHS, an impaired verticality representation results from a kind of graviceptive neglect, bearing first on somaesthetic graviception and second on vestibular graviception. They also suggest that the human brain uses not only a mosaic of 2D representations but also 3D maps involving a transmodal representation of verticality.
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Affiliation(s)
- Rémi Lafitte
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Marie Jeager
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Céline Piscicelli
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Shenhao Dai
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Camille Lemaire
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Anne Chrispin
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Patrice Davoine
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Eve Dupierrix
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Dominic Pérennou
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
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Moro V, Pacella V, Scandola M, Besharati S, Rossato E, Jenkinson P, Fotopoulou A. A fronto-insular-parietal network for the sense of body ownership. Cereb Cortex 2023; 33:512-522. [PMID: 35235644 PMCID: PMC7614133 DOI: 10.1093/cercor/bhac081] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 02/04/2023] Open
Abstract
Neuropsychological disturbances in the sense of limb ownership provide unique opportunities to study the neurocognitive basis of body ownership. Previous small sample studies that showed discrete cortical lesions cannot explain why multisensory, affective, and cognitive manipulations alter disownership symptoms. We tested the novel hypothesis that disturbances in the sense of limb ownership would be associated not only with discrete cortical lesions but also with disconnections of white-matter tracts supporting specific functional networks. We drew on an advanced lesion-analysis and Bayesian statistics approach in 49 right-hemisphere patients (23 with and 26 without limb disownership). Our results reveal that disturbances in the sense of ownership are associated with lesions in the supramarginal gyrus and disconnections of a fronto-insular-parietal network, involving the frontal-insular and frontal inferior longitudinal tracts, confirming previous disconnection hypotheses. Together with previous behavioral and neuroanatomical results, these findings lead us to propose that the sense of body ownership involves the convergence of bottom-up, multisensory integration, and top-down monitoring of sensory salience based on contextual demands.
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Affiliation(s)
- V. Moro
- NPSY-Lab.VR, Department of Human Sciences, University of Verona, 37129 Verona, Italy
| | - V. Pacella
- NPSY-Lab.VR, Department of Human Sciences, University of Verona, 37129 Verona, Italy,Groupe d’Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, CS F-33076 Bordeaux
| | - M. Scandola
- NPSY-Lab.VR, Department of Human Sciences, University of Verona, 37129 Verona, Italy
| | - S. Besharati
- Department of Psychology, School of Human and Community Development, University of Witwatersrand, 2000 Johannesburg, South Africa,CIFAR Azrieli Global Scholars program, CIFAR, Toronto, ON M5G 1M1 Canada
| | - E. Rossato
- Department of Rehabilitation, IRCSS Sacro Cuore Don Calabria, 37024, Negrar, Verona, Italy
| | - P.M. Jenkinson
- Institute for Social Neuroscience, Ivanhoe, Melbourne, Victoria. Australia
| | - A Fotopoulou
- Department of Clinical, Educational and Health Psychology, University College of London, London WC1E 6BT, UK
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Cocchini G, Scandola M, Gobbetto V, Cioffi MC, Bartolo A, Moore J, Moro V. The 'healthy side' of anosognosia for hemiplegia: Increased sense of agency for the unimpaired limb or motor compensation? Neuropsychologia 2022; 177:108421. [PMID: 36370826 DOI: 10.1016/j.neuropsychologia.2022.108421] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/28/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Anosognosic patients show a lack of awareness for their hemiplegia coupled with a distorted sense of agency for the actions performed by the plegic limbs. Since anosognosia is often associated with right brain damage, this hemisphere seems to play a dominant role in monitoring awareness for motor actions. Therefore, we would expect that anosognosic patients show distorted awareness and sense of agency also for actions performed with the unimpaired limb. METHOD To test this hypothesis, we induced illusory actions that could be congruent or incongruent with a preceding verbal command. A group of 16 right brain-damaged patients performed this task and then rated i) their ability to anticipate the actions, ii) their sense of agency and iii) their sense of ownership for each limb. Measures of awareness, neglect and motor impairment were also considered for the patient group. RESULTS Following incongruent actions with the unimpaired limb, less aware patients showed a relatively mild distortion in all three aspects. In addition, we also found a crucial relationship between motor impairment (for the plegic limb) and sense of agency for both plegic and healthy limbs. CONCLUSION Although the distortion linked to both limbs supports the initial hypothesis that the right hemisphere is responsible for monitoring awareness for action for the whole body, our data also suggest that the observed distortion may be linked to a motor compensatory phenomenon, not necessarily related to awareness processes.
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Affiliation(s)
| | | | - Valeria Gobbetto
- Department of Human Sciences, Verona University, Italy; IRCSS Sacro Cuore Don Calabria, Negrar Verona, Italy
| | | | - Angela Bartolo
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France; Institut Universitaire de France (IUF), France
| | - James Moore
- Psychology Department, Goldsmiths University of London, UK
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10
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Pacella V, Scandola M, Bà M, Smania N, Beccherle M, Rossato E, Volpe D, Moro V. Temporal judgments of actions following unilateral brain damage. Sci Rep 2022; 12:21668. [PMID: 36522442 PMCID: PMC9755153 DOI: 10.1038/s41598-022-26070-9] [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: 05/31/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
Sense of time is a complex construct, and its neural correlates remain to date in most part unknown. To complicate the frame, physical attributes of the stimulus, such as its intensity or movement, influence temporal perception. Although previous studies have shown that time perception can be compromised after a brain lesion, the evidence on the role of the left and right hemispheres are meager. In two experiments, the study explores the ability of temporal estimation of multi-second actions and non-biological movements in 33 patients suffering from unilateral brain lesion. Furthermore, the modulatory role of induced embodiment processes is investigated. The results reveal a joint contribution of the two hemispheres depending not only on different durations but also on the presence of actions. Indeed, the left hemisphere damaged patients find it difficult to estimate 4500 ms or longer durations, while the right hemisphere damaged patients fail in 3000 ms durations. Furthermore, the former fail when a biological action is shown, while the latter fail in non-biological movement. Embodiment processes have a modulatory effect only after right hemisphere lesions. Among neuropsychological variables, only spatial neglect influences estimation of non-biological movement.
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Affiliation(s)
- Valentina Pacella
- grid.412041.20000 0001 2106 639XGroupe d’Imagerie NeurofonctionnelleInstitut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA, University of Bordeaux, 146 Rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France ,grid.462844.80000 0001 2308 1657Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France
| | - M. Scandola
- grid.5611.30000 0004 1763 1124NPSY-Lab.VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
| | - M. Bà
- grid.5611.30000 0004 1763 1124NPSY-Lab.VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
| | - N. Smania
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy
| | - M. Beccherle
- grid.7841.aDepartment of Psychology, University La Sapienza, Rome, Italy
| | - E. Rossato
- Department of Rehabilitation, IRCSS Sacro Cuore Don Calabria, 37024 Negrar, Verona, Italy
| | - D. Volpe
- Department of Neurorehabilitation, Parkinson’s Disease Excellence Center, Fresco Institute Italy - NYU Langone, Casa di Cura Villa Margherita via Costacolonna n 1 Arcugnano, Vicenza, Italy
| | - Valentina Moro
- grid.5611.30000 0004 1763 1124NPSY-Lab.VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
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11
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Abstract
Personal neglect is a disorder in the perception and representation of the body that causes the patients to behave as if the contralesional side of their body does not exist. This clinical condition has not been adequately investigated in the past as it has been considered a symptom of unilateral spatial neglect, which has mainly been studied with reference to extrapersonal space. Only a few studies with small samples have investigated the neuroanatomical correlates of personal neglect, and these have mainly focused on discrete cortical lesions and modular accounts, as well as being based on the hypothesis that this disorder is associated with somatosensory and spatial deficits. In the present study, we tested the novel hypothesis that personal neglect may be associated not only with discrete cortical and subcortical lesions, but also with disconnections of white matter tracts. We performed an advanced lesion analyses in a large sample of 104 right hemisphere damaged patients, 72 of whom were suffering from personal neglect. Results from the analyses of the grey and white matter were controlled for co-occurrent clinical variables such as extrapersonal neglect, anosognosia for hemiplegia and motor deficits, along with other lesion-related variables such as lesion size and the interval from the lesion onset to neuroimaging recordings. Our results reveal that personal neglect is associated with lesions in a medial network which involves the temporal cortex (Heschl's gyrus), the ventro-lateral nuclei of the thalamus and the fornix. This suggests that personal neglect involves a convergence between sensorimotor processes, spatial representation and the processing of self-referred information (episodic memory).
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Umeonwuka CI, Roos R, Ntsiea V. Current knowledge and practice of post-stroke unilateral spatial neglect rehabilitation: A cross-sectional survey of South African neurorehabilitation physiotherapists. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2022; 78:1624. [PMID: 35402745 PMCID: PMC8991368 DOI: 10.4102/sajp.v78i1.1624] [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: 09/06/2021] [Accepted: 01/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Unilateral spatial neglect (USN) affects the rehabilitation process leading to poor functional outcomes after stroke. South African physiotherapists’ level of uptake of available evidence in USN rehabilitation and the barriers they encounter are not known. Objectives To evaluate knowledge, current practice enablers and barriers to USN management in stroke survivors amongst physiotherapists in South Africa. Methods Our cross-sectional survey used a total sampling technique. Questionnaires were sent to neurorehabilitation physiotherapists in South Africa. Descriptive and inferential statistics analysed the data. Results The overall knowledge score of USN was 14.11 ± 5.23 of a total of 25. The knowledge was good for definitions of USN; moderate for incidences, causes, screening, diagnosis and prognosis of USN and poor for pharmacological approaches to the management of USN. A significant low positive correlation between respondents’ age (r = 0.46; p = 0.016) and years of practice as a physiotherapist (r = 0.43; p = 0.026) and knowledge of USN was found. The most frequently utilised intervention was constraint-induced movement therapy; the commonly utilised assessment tool was the comb and razor test. ‘Inadequate therapy time’ (55.56%) and ‘lack of relevant equipment for rehabilitation of USN’ (38.89%) were identified as major barriers to USN rehabilitation. Major enablers to USN rehabilitation were the ‘presence of multidisciplinary stroke team in clinical practice’ (83.35%) and ‘availability of adequate staff’ (76.47%). Conclusion Physiotherapists demonstrated a fair knowledge of USN although knowledge about pharmacological management of USN was modest. Current practice in post-stroke USN by South African neuro-physiotherapists follows current evidence and practice guidelines. Clinical implication Our study shows the level of knowledge and current practice of post-stroke USN rehabilitation. The demonstrated fair knowledge of USN may be improved through training, curriculum modifications or continuing professional development. Identified barriers to the rehabilitation of post-stroke USN can assist health policy, managers and clinicians to improve stroke-specific care.
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Affiliation(s)
- Chuka I Umeonwuka
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ronel Roos
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Veronica Ntsiea
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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13
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Awareness is in the eye of the observer: Preserved third-person awareness of deficit in anosognosia for hemiplegia. Neuropsychologia 2022; 170:108227. [DOI: 10.1016/j.neuropsychologia.2022.108227] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/28/2022] [Accepted: 03/23/2022] [Indexed: 11/23/2022]
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14
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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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15
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Chapman A, Chapman S, Cosentino S. Bodies in the Novel Infinite Jest. Front Psychol 2021; 12:539555. [PMID: 34566734 PMCID: PMC8459868 DOI: 10.3389/fpsyg.2021.539555] [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] [Received: 03/01/2020] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
This manuscript provides a literary analysis of the use of bodies in the novel Infinite Jest by David Foster Wallace. The novel describes a world where oversaturation of external stimulation leads to the perception of mind and body of self of an individual as prosthetic parts, malleable and deformed, wherein the mind fails to feel bodily sensations and characters experience a complete disconnectedness from the self and others. Indeed, the disembodiment of characters and sensations of disconnection leads them to a compulsive quest for connectedness through the use of masks, made-up feelings, mind-body hybrid pain, corporeal malleability, and prostheses. These portrayals of the disordered and disconnectedness between body and mind or self will be described and compared to clinical conditions characterized by a disconnection between mind and body and impaired body self-awareness. Through this exercise, we argue that the use of scientifically inspired pathologized bodies is a means of conveying the stance of Wallace on or criticism of the degradation of society through excessive entertainment.
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Affiliation(s)
- Ana Chapman
- Department of English, French and German, Faculty of Arts, University of Málaga, Málaga, Spain
| | - Silvia Chapman
- Cognitive Neuroscience Division, Taub Institute for Research on Alzheimer's Disease and Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, United States
| | - Stephanie Cosentino
- Cognitive Neuroscience Division, Taub Institute for Research on Alzheimer's Disease and Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, United States
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
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16
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Kirsch LP, Mathys C, Papadaki C, Talelli P, Friston K, Moro V, Fotopoulou A. Updating beliefs beyond the here-and-now: the counter-factual self in anosognosia for hemiplegia. Brain Commun 2021; 3:fcab098. [PMID: 34151264 PMCID: PMC8209286 DOI: 10.1093/braincomms/fcab098] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
The syndrome of anosognosia for hemiplegia, or the lack of awareness for one’s paralysis following right hemisphere stroke, can provide unique insights into the neurocognitive mechanisms of self-awareness. Yet it remains unclear whether anosognosia for hemiplegia is a modality-specific deficit of sensorimotor monitoring, or whether domain-general processes of attention and belief-updating converge to cause anosognosia for hemiplegia. Using a Bayesian learning framework, we formalized and empirically investigated the hypothesis that failures to update anosognosic beliefs can be explained by abnormalities in the relative uncertainty (i.e. precision) ascribed to prior beliefs versus sensory information in different contexts. We designed a new motor belief-updating task that manipulated both the temporal (prospective and retrospective) and spatial (hemispace most affected by inattention and hemispace less affected by inattention) conditions in which beliefs had to be updated, and we validated its sensitivity to anosognosia for hemiplegia in 26 patients with right hemisphere stroke. We then computed and empirically tested two different Bayesian predictors of prospective beliefs using two proxies for precision in anosognosia for hemiplegia patients: (i) standardized, neuropsychological measures of objective attention abilities, i.e. visuospatial neglect scores and (ii) subjective uncertainty reports, i.e. confidence ratings. Our results suggest that while neglect does not affect local, sensorimotor error monitoring, it does seem to affect the degree to which observed errors are used to update more general, prospective beliefs about counterfactual motor abilities in anosognosia for hemiplegia. Difficulties in such ‘counterfactual’ belief-updating were associated with disruptions in tracts of the ventral attentional network (i.e. superior longitudinal fasciculus connecting the temporo-parietal junction and ventral frontal cortex) and associated lesions to the insula, inferior parietal cortex and superior temporal regions. These results suggest that self-awareness extends beyond local, retrospective monitoring, requiring also salience-based, convergence of beliefs about the self that go beyond the ‘here-and-now’ of sensorimotor experience.
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Affiliation(s)
- Louise P Kirsch
- Institut des Systèmes Intelligents et de Robotique, Sorbonne Université, Paris 75005, France.,Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
| | - Christoph Mathys
- Scuola Internazionale Superiore di Studi Avanzati (SISSA), Trieste 34136, Italy.,Interacting Minds Centre, Aarhus University, Aarhus 8000, Denmark.,Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich 8032, Switzerland
| | - Christina Papadaki
- Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
| | | | - Karl Friston
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Valentina Moro
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Verona 37129, Italy
| | - Aikaterini Fotopoulou
- Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
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17
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Pacella V, Ricciardi GK, Bonadiman S, Verzini E, Faraoni F, Scandola M, Moro V. The Role of White Matter Disconnection in the Symptoms Relating to the Anarchic Hand Syndrome: A Single Case Study. Brain Sci 2021; 11:brainsci11050632. [PMID: 34069300 PMCID: PMC8156999 DOI: 10.3390/brainsci11050632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 01/28/2023] Open
Abstract
The anarchic hand syndrome refers to an inability to control the movements of one’s own hand, which acts as if it has a will of its own. The symptoms may differ depending on whether the brain lesion is anterior, posterior, callosal or subcortical, but the relative classifications are not conclusive. This study investigates the role of white matter disconnections in a patient whose symptoms are inconsistent with the mapping of the lesion site. A repeated neuropsychological investigation was associated with a review of the literature on the topic to identify the frequency of various different symptoms relating to this syndrome. Furthermore, an analysis of the neuroimaging regarding structural connectivity allowed us to investigate the grey matter lesions and white matter disconnections. The results indicated that some of the patient’s symptoms were associated with structures that, although not directly damaged, were dysfunctional due to a disconnection in their networks. This suggests that the anarchic hand may be considered as a disconnection syndrome involving the integration of multiple antero-posterior, insular and interhemispheric networks. In order to comprehend this rare syndrome better, the clinical and neuroimaging data need to be integrated with the clinical reports available in the literature on this topic.
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Affiliation(s)
- Valentina Pacella
- Npsy.Lab-VR, Dipartimento di Scienze Umane, Università di Verona, Lungadige Porta Vittoria, 17-37129 Verona, Italy; (V.P.); (F.F.); (M.S.)
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, 75006 Paris, France
- Groupe d’Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, 33076 Bordeaux, France
| | - Giuseppe Kenneth Ricciardi
- Neuroradiology, AOUVR Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani, 1-37126 Verona, Italy;
| | - Silvia Bonadiman
- IRCSS, Ospedale Sacro Cuore-Don Calabria, Via Rizzardi, 4-37024 Negrar di Valpolicella, Italy; (S.B.); (E.V.)
| | - Elisabetta Verzini
- IRCSS, Ospedale Sacro Cuore-Don Calabria, Via Rizzardi, 4-37024 Negrar di Valpolicella, Italy; (S.B.); (E.V.)
| | - Federica Faraoni
- Npsy.Lab-VR, Dipartimento di Scienze Umane, Università di Verona, Lungadige Porta Vittoria, 17-37129 Verona, Italy; (V.P.); (F.F.); (M.S.)
| | - Michele Scandola
- Npsy.Lab-VR, Dipartimento di Scienze Umane, Università di Verona, Lungadige Porta Vittoria, 17-37129 Verona, Italy; (V.P.); (F.F.); (M.S.)
| | - Valentina Moro
- Npsy.Lab-VR, Dipartimento di Scienze Umane, Università di Verona, Lungadige Porta Vittoria, 17-37129 Verona, Italy; (V.P.); (F.F.); (M.S.)
- Correspondence: ; Tel.: +39-45-8028370
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18
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Toba MN, Pagliari C, Rabuffetti M, Nighoghossian N, Rode G, Cotton F, Spinazzola L, Baglio F, Migliaccio R, Bartolomeo P. Quantitative Assessment of Motor Neglect. Stroke 2021; 52:1618-1627. [PMID: 33657852 DOI: 10.1161/strokeaha.120.031949] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Monica N Toba
- Sorbonne Université, Inserm U 1127, CNRS UMR 7225, Paris Brain Institute, ICM, Hôpital de la Pitié-Salpêtrière, France (M.N.T., R.M., P.B.).,Laboratory of Functional Neurosciences (UR UPJV 4559), University of Picardy Jules Verne and University Hospital of Amiens, France (M.N.T.)
| | - Chiara Pagliari
- IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy (C.P., M.R., F.B.)
| | - Marco Rabuffetti
- IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy (C.P., M.R., F.B.)
| | - Norbert Nighoghossian
- Stroke Department, Claude Bernard University Lyon 1, Laboratoire CarMeN, Inserm U 1060, Université Lyon 1, INRA U 1397, INSA Lyon, Hospices Civils de Lyon, France (N.N.)
| | - Gilles Rode
- Service de médecine physique et réadaptation, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 69610 Pierre-Bénite, France (G.R.).,Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, Claude Bernard University Lyon 1, Bron, France (G.R.).,Claude Bernard University Lyon 1, 69008 Lyon, France (G.R.)
| | - François Cotton
- Laboratoire CREATIS, CNRS UMR 5220, Inserm U 1206, INSA-Lyon, Claude Bernard University Lyon 1, Lyon, France (F.C.).,Service de Radiologie, Centre Hospitalier de Lyon Sud, Hospices Civils de Lyon, France (F.C.)
| | | | - Francesca Baglio
- IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy (C.P., M.R., F.B.)
| | - Raffaella Migliaccio
- Sorbonne Université, Inserm U 1127, CNRS UMR 7225, Paris Brain Institute, ICM, Hôpital de la Pitié-Salpêtrière, France (M.N.T., R.M., P.B.).,Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Paris, France (R.M.).,FrontLab, ICM, Paris, France (R.M.)
| | - Paolo Bartolomeo
- Sorbonne Université, Inserm U 1127, CNRS UMR 7225, Paris Brain Institute, ICM, Hôpital de la Pitié-Salpêtrière, France (M.N.T., R.M., P.B.)
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19
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Caggiano P, Veronelli L, Mora L, Arduino LS, Corbo M, Cocchini G. The downsized hand in personal neglect. J Clin Exp Neuropsychol 2020; 42:1072-1084. [PMID: 33203298 DOI: 10.1080/13803395.2020.1843603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction: Personal neglect (PN) refers to a form of hemi-inattention toward the contralesional body space and it usually occurs following a right brain lesion. Recent studies suggest that PN indicates a disorder of body representation. Specifically, patients with PN show difficulties in identifying differences between left and right hands and have an altered visuospatial body map, which is associated with disrupted mental body representations. However, the metric representation of the body, and in particular the hands, has not been systematically addressed in patients showing this form of neglect. Method: In the present study, we have investigated this representation by testing the perceived hands' width of 11 hemiplegic patients with right hemisphere cerebral lesions (5 with PN) and 12 healthy controls on a judgment of passability task. Patients and controls were asked to imagine inserting their hand (left and right) through a series of vertical apertures of different sizes and to judge whether their hand could fit through. Due to the heterogeneity of the data, both parametric and non-parametric approaches were used. Furthermore, additional single-case analyses were conducted. Results: Study findings showed that patients with PN showed a significant underestimation of the left hand compared with their right hand. In contrast, whilst the right hand was equally distorted in both patients' groups, the hemiplegic patients with no evidence of PN tended to perceive the affected hand as larger than their ipsilesional one. Conclusions: In line with the literature, our findings confirm an underlying distorted body representation following right brain damage. However, for the first time, we report both a quantitative and qualitative difference in impact of hemiplegia and PN on body representation of the contralesional body space.
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Affiliation(s)
- Pietro Caggiano
- Department of Psychology, Goldsmiths University of London , London, UK
| | - Laura Veronelli
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico , Milano, Italy
| | - Laura Mora
- Department of Psychology, Goldsmiths University of London , London, UK
| | - Lisa S Arduino
- Department of Human Sciences, Lumsa University , Roma, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico , Milano, Italy
| | - Gianna Cocchini
- Department of Psychology, Goldsmiths University of London , London, UK
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20
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Cocchini G, Beschin N. The Fluff test: Improved scoring system to account for different degrees of contralesional and ipsilesional personal neglect in brain damaged patients. Neuropsychol Rehabil 2020; 32:69-83. [PMID: 32723030 DOI: 10.1080/09602011.2020.1797828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The Fluff test is a simple test to assess evidence of personal neglect (PN) in brain-damaged patients. While blindfolded, patients are asked to remove targets previously attached to their body and the number of targets detached provides information about possible spatial bias. This test has been widely used for clinical and research purposes. However, the current scoring system presents some limitations, which make difficult to interpret patients' performance in terms of both contralalesional and ipsilesional PN when they omit targets on the ipsilesional side. Moreover, it does not consider possible confounding variables, such as non-spatial cognitive deficits or lack of compliance that may affect patients' performance and lead to incorrect diagnosis. The present paper proposes a new scoring method overcoming the limitations mentioned above and it analyses data from a large sample of 243 brain-damaged patients. Findings showed that contralesional PN was significantly more severe, but not more frequent, following right (31%) than left (21%) brain damage. We also found evidence of left ipsilesional PN and cases of potential mis-diagnosis that would have passed unnoticed with the original scoring system. The new scoring method allows to identify different degrees of contralesional and ipsilesional PN and potential confounding variable.
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Affiliation(s)
- Gianna Cocchini
- Psychology Department, Goldsmiths University of London, London, UK
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21
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Spinazzola L, Pagliari C, Facchin A, Maravita A. A new clinical evaluation of asomatognosia in right brain damaged patients using visual and reaching tasks. J Clin Exp Neuropsychol 2020; 42:436-449. [PMID: 32380939 DOI: 10.1080/13803395.2020.1757040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The term asomatognosia refers to a unilateral disturbance of body ownership following a cerebrovascular incident. Patients with asomatognosia consider the contralesional limbs as missing or having disappeared from awareness. This neuropsychological disorder modifies body ownership in terms of perceptual experience, visual identification and sense of belonging of contralesional body parts. In the literature, asomatognosia is usually tested by using verbal scales. METHOD In this study, we first developed a new test to assess asomatognosia that includes a visual identification task and a reaching task. We examined 16 healthy participants and 20 right brain damaged patients. The participants were asked to identify, reach and touch their left hand when positioned in peripersonal space, in presence of an extraneous hand (belonging to the examiner). We analyzed how the deficit is modulated by the reciprocal positions in space of the two limbs, the relationship with personal neglect and the anatomical correlate using a Voxel-based Lesion Symptom Mapping (VLSM) analysis with CT data. RESULTS The results show that the asomatognosia cannot be simply considered as one of the many manifestations of personal neglect but should be taken into account as a "productive" disorder characterized by the misidentification of the own hand with an extraneous hand. The VLSM analysis of patients with asomatognosia revealed the involvement of the inferior and middle frontal lobe. CONCLUSIONS The novel task that has been developed in the present study could be used as an objective tool to measure this specific disorder of body ownership or to uncover subclinical conditions of asomatognosia.
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Affiliation(s)
- Lucia Spinazzola
- Humanitas Mater Domini Hospital , Castellanza, Italy.,Rehabilitation Department, Neuropsychological Service , Somma Lombardo, Italy
| | - Chiara Pagliari
- IRCCS Maria Nascente, Fondazione Don Carlo Gnocchi ONLUS , Milano, Italy
| | - Alessio Facchin
- Department of Psychology, University of Milano Bicocca , Milan, Italy.,Institute of Research and Studies in Optics and Optometry , Vinci, Italy
| | - Angelo Maravita
- Department of Psychology, University of Milano Bicocca , Milan, Italy.,Milan Centre for Neuroscience , Milano, Italy
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22
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Jenkinson PM, Papadaki C, Besharati S, Moro V, Gobbetto V, Crucianelli L, Kirsch LP, Avesani R, Ward NS, Fotopoulou A. Welcoming back my arm: affective touch increases body ownership following right-hemisphere stroke. Brain Commun 2020; 2:fcaa034. [PMID: 32954292 PMCID: PMC7425337 DOI: 10.1093/braincomms/fcaa034] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/13/2020] [Accepted: 03/02/2020] [Indexed: 12/11/2022] Open
Abstract
Right-hemisphere stroke can impair the ability to recognize one’s contralesional body parts as belonging to one’s self. The study of this so-called ‘disturbed sense of limb ownership’ can provide unique insights into the neurocognitive mechanisms of body ownership. In this study, we address a hypothesis built upon experimental studies on body ownership in healthy volunteers. These studies have shown that affective (pleasant) touch, an interoceptive modality associated with unmyelinated, slow-conducting C-tactile afferents, has a unique role in the sense of body ownership. In this study, we systematically investigated whether affective touch stimulation could increase body ownership in patients with a disturbed sense of limb ownership following right-hemisphere stroke. An initial feasibility study in 16 adult patients with acute stroke enabled us to optimize and calibrate an affective touch protocol to be administered by the bedside. The main experiment, conducted with a different sample of 26 right hemisphere patients, assessed changes in limb ownership elicited following self- (patient) versus other- (experimenter) generated tactile stimulation, using a velocity known to optimally activate C-tactile fibres (i.e. 3 cm/s), and a second velocity that is suboptimal for C-tactile activation (i.e. 18 cm/s). We further examined the specificity and mechanism of observed changes in limb ownership in secondary analyses looking at (i) the influence of perceived intensity and pleasantness of touch, (ii) touch laterality and (iii) level of disturbed sense of limb ownership on ownership change and (iv) changes in unilateral neglect arising from touch. Findings indicated a significant increase in limb ownership following experimenter-administered, C-tactile-optimal touch. Voxel-based lesion-symptom mapping identified damage to the right insula and, more substantially, the right corpus callosum, associated with a failure to increase body ownership following experimenter-administered, affective touch. Our findings suggest that affective touch can increase the sense of body-part ownership following right-hemisphere stroke, potentially due to its unique role in the multisensory integration processes that underlie the sense of body ownership.
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Affiliation(s)
- Paul M Jenkinson
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
- Correspondence to: Paul Jenkinson, PhD, School of Life and Medical Sciences University of Hertfordshire, Hatfield AL10 9AB, UK E-mail:
| | - Cristina Papadaki
- Division of Psychology and Language Science, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Sahba Besharati
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Valentina Moro
- NPSY.Lab_VR, Department of Human Sciences, University of Verona, Verona, Italy
| | - Valeria Gobbetto
- NPSY.Lab_VR, Department of Human Sciences, University of Verona, Verona, Italy
| | - Laura Crucianelli
- Division of Psychology and Language Science, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Louise P Kirsch
- Division of Psychology and Language Science, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Institut des Systèmes Intelligents et de Robotique, Sorbonne Université, Paris, France
| | | | - Nick S Ward
- Department of Clinical and Motor Neuroscience, UCL Institute of Neurology, London, UK
| | - Aikaterini Fotopoulou
- Division of Psychology and Language Science, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Kirsch LP, Besharati S, Papadaki C, Crucianelli L, Bertagnoli S, Ward N, Moro V, Jenkinson PM, Fotopoulou A. Damage to the right insula disrupts the perception of affective touch. eLife 2020; 9:e47895. [PMID: 31975686 PMCID: PMC7043887 DOI: 10.7554/elife.47895] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 01/23/2020] [Indexed: 12/29/2022] Open
Abstract
Specific, peripheral C-tactile afferents contribute to the perception of tactile pleasure, but the brain areas involved in their processing remain debated. We report the first human lesion study on the perception of C-tactile touch in right hemisphere stroke patients (N = 59), revealing that right posterior and anterior insula lesions reduce tactile, contralateral and ipsilateral pleasantness sensitivity, respectively. These findings corroborate previous imaging studies regarding the role of the posterior insula in the perception of affective touch. However, our findings about the crucial role of the anterior insula for ipsilateral affective touch perception open new avenues of enquiry regarding the cortical organization of this tactile system.
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Affiliation(s)
- Louise P Kirsch
- Department of Clinical, Educational and Health Psychology, University College LondonLondonUnited Kingdom
- Institut des Systèmes Intelligents et de Robotique, Sorbonne UniversitéParisFrance
| | - Sahba Besharati
- Department of Psychology, University of the WitwatersrandJohannesburgSouth Africa
| | - Christina Papadaki
- Department of Clinical, Educational and Health Psychology, University College LondonLondonUnited Kingdom
| | - Laura Crucianelli
- Department of Clinical, Educational and Health Psychology, University College LondonLondonUnited Kingdom
- Department of Neuroscience, Karolinska InstitutetStockholmSweden
| | - Sara Bertagnoli
- NPSY.Lab-VR, Department of Human Sciences, University of VeronaVeronaItaly
| | - Nick Ward
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of NeurologyLondonUnited Kingdom
| | - Valentina Moro
- NPSY.Lab-VR, Department of Human Sciences, University of VeronaVeronaItaly
| | - Paul M Jenkinson
- Department of Psychology, School of Life and Medical Sciences, University of HertfordshireHatfieldUnited Kingdom
| | - Aikaterini Fotopoulou
- Department of Clinical, Educational and Health Psychology, University College LondonLondonUnited Kingdom
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Sakamoto K, Yokoi K, Hirayama K, Yamaguchi J, Shinoda A. A case of somatoparaphrenia characterized by very mild somatosensory disturbance and absence of anosognosia for hemiplegia and personal neglect. Cortex 2019; 120:603-606. [DOI: 10.1016/j.cortex.2019.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 11/26/2022]
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25
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Pacella V, Foulon C, Jenkinson PM, Scandola M, Bertagnoli S, Avesani R, Fotopoulou A, Moro V, Thiebaut de Schotten M. Anosognosia for hemiplegia as a tripartite disconnection syndrome. eLife 2019; 8:e46075. [PMID: 31383259 PMCID: PMC6684265 DOI: 10.7554/elife.46075] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/20/2019] [Indexed: 11/26/2022] Open
Abstract
The syndrome of Anosognosia for Hemiplegia (AHP) can provide unique insights into the neurocognitive processes of motor awareness. Yet, prior studies have only explored predominately discreet lesions. Using advanced structural neuroimaging methods in 174 patients with a right-hemisphere stroke, we were able to identify three neural systems that contribute to AHP, when disconnected or directly damaged: the (i) premotor loop (ii) limbic system, and (iii) ventral attentional network. Our results suggest that human motor awareness is contingent on the joint contribution of these three systems.
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Affiliation(s)
- Valentina Pacella
- Social and Cognitive Neuroscience Laboratory, Department of PsychologySapienza University of RomeRomeItaly
- NPSY.Lab-VR, Department of Human SciencesUniversity of VeronaVeronaItaly
| | - Chris Foulon
- Brain Connectivity and Behaviour LaboratorySorbonne UniversitiesParisFrance
- Frontlab, Institut du Cerveau et de la Moelle épinière (ICM)UPMC UMRS 1127, Inserm U 1127, CNRS UMR 7225ParisFrance
- Computational Neuroimaging Laboratory, Department of Diagnostic MedicineThe University of Texas at Austin Dell Medical SchoolAustinUnited States
| | - Paul M Jenkinson
- School of Life and Medical SciencesUniversity of HertfordshireHatfieldUnited Kingdom
| | - Michele Scandola
- NPSY.Lab-VR, Department of Human SciencesUniversity of VeronaVeronaItaly
| | - Sara Bertagnoli
- NPSY.Lab-VR, Department of Human SciencesUniversity of VeronaVeronaItaly
| | - Renato Avesani
- Department of RehabilitationIRCSS Sacro Cuore-Don Calabria HospitalVeronaItaly
| | - Aikaterini Fotopoulou
- Clinical, Educational and Health Psychology, Division of Psychology and Language SciencesUniversity College LondonLondonUnited Kingdom
| | - Valentina Moro
- NPSY.Lab-VR, Department of Human SciencesUniversity of VeronaVeronaItaly
| | - Michel Thiebaut de Schotten
- Brain Connectivity and Behaviour LaboratorySorbonne UniversitiesParisFrance
- Frontlab, Institut du Cerveau et de la Moelle épinière (ICM)UPMC UMRS 1127, Inserm U 1127, CNRS UMR 7225ParisFrance
- Groupe d’Imagerie NeurofonctionnelleInstitut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of BordeauxBordeauxFrance
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26
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Bosma MS, Nijboer TCW, Caljouw MAA, Achterberg WP. Impact of visuospatial neglect post-stroke on daily activities, participation and informal caregiver burden: A systematic review. Ann Phys Rehabil Med 2019; 63:344-358. [PMID: 31200080 DOI: 10.1016/j.rehab.2019.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/25/2019] [Accepted: 05/08/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Visuospatial neglect (VSN) is a common cognitive disorder after stroke. The primary aim of this systematic review was to provide an overview of the impact of VSN in 3 aspects: (1) activities of daily living (ADL), (2) participation, and (3) caregiver burden. The second aim was to investigate the differences in studies focusing on populations with mean age<65 versus≥65 years. METHODS PubMed, EMBASE, Web of Science, Cochrane Library, Emcare, PsychINFO, Academic Search Premier and CENTRAL were searched systematically. Quality was assessed with the Mixed Methods Appraisal Tool. RESULTS Of the 115 included studies, 104 provided outcomes on ADL, 15 on participation (4 studies with mean age≥65), and 2 on caregiver burden (1 study with mean age≥65). Quality assessment yielded scores ranging from 0 to 100%. VSN had a negative impact on ADL (i.e., independence during ADL and performance in self-care, household tasks, reading, writing, walking, wheelchair navigation) and participation (i.e., driving, community mobility, orientation, work). The impact of VSN on fulfilling social roles was unclear. VSN had a negative effect on caregiver burden. We found no clear age-related differences. CONCLUSIONS AND IMPLICATIONS VSN has a negative impact not only on patients' independence but particularly on the performance of ADL. Despite the far fewer studies of VSN as compared with ADL, VSN also seems to hamper participation and increase caregiver burden, but further research is needed. Because of the large impact, VSN should be systematically and carefully assessed during rehabilitation. A considerable number of different instruments were used to diagnose VSN. Diagnosing VSN at more than one level [function (i.e., pen-and-paper test), activities, and participation] is strongly recommended. Consensus is needed on how to assess VSN and its negative impact for research and rehabilitation practice. SYSTEMATIC REVIEW REGISTRATION NO PROSPERPO Registration No. CRD42018087483.
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Affiliation(s)
- Martine S Bosma
- Department of public health and primary care, Leiden university medical center, Post zone V0-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands; Zorggroep Florence, Laan van Vredenoord 1, 2289 DA, Rijswijk, The Netherlands.
| | - Tanja C W Nijboer
- Center of excellence for rehabilitation medicine, UMC Utrecht brain center, university medical center Utrecht, and De Hoogstraat rehabilitation, Utrecht, The Netherlands; Utrecht university, department of experimental psychology, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
| | - Monique A A Caljouw
- Department of public health and primary care, Leiden university medical center, Post zone V0-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Wilco P Achterberg
- Department of public health and primary care, Leiden university medical center, Post zone V0-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
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27
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Varalta V, Munari D, Pertile L, Fonte C, Vallies G, Chemello E, Gandolfi M, Modenese A, Smania N, Picelli A. Effects of Neck Taping in the Treatment of Hemispatial Neglect in Chronic Stroke Patients: A Pilot, Single Blind, Randomized Controlled Trial. ACTA ACUST UNITED AC 2019; 55:medicina55040108. [PMID: 30999679 PMCID: PMC6524060 DOI: 10.3390/medicina55040108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/04/2019] [Accepted: 04/12/2019] [Indexed: 12/04/2022]
Abstract
Background and objectives: Hemispatial neglect is a common consequence of stroke, with an estimated incidence of 23%. Interventions for treating hemispatial neglect may be categorized as either top-down or bottom-up processing. The aim of top-down approaches is to train the person to voluntarily compensate for their neglect. Such approaches require awareness of the disorder and a high level of active participation by the patient. Differently, bottom-up approaches are based on manipulation of a patient’s sensory environment and so require less awareness of behavioral bias. In line with the latter, it is conceivable that elastic therapeutic taping applied to the left neck surface may provide bottom-up inputs that reduce hemispatial neglect symptoms. The aim of this study was to assess the effect of therapeutic neck taping on visuo-spatial abilities, neck motion, and kinesthetic sensibility in chronic stroke patients with hemispatial neglect. Materials and Methods: After randomization, 12 chronic stroke patients with hemispatial neglect received 30 consecutive days of real (treatment group) or sham (control group) neck taping. The outcomes were as follows: Stars Cancellation Test; neck active range of motion; Letter Cancellation Test; Comb and Razor Test; Cervical Joint Position Error Test evaluated before and after one month of taping. Results: Between-group comparison showed significant differences only for the Cervical Joint Position Error Test after treatment (p = 0.009). Conclusions: Our preliminary findings support the hypothesis that neck taping might improve cervicocephalic kinesthetic sensibility in chronic stroke patients with hemispatial neglect. Further studies are needed to strengthen our results and better investigate the effects of elastic therapeutic taping on visuo-spatial abilities in stroke patients with hemispatial neglect.
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Affiliation(s)
- Valentina Varalta
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.
| | - Daniele Munari
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy.
| | - Lucrezia Pertile
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.
| | - Cristina Fonte
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.
| | - Gabriella Vallies
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.
| | - Elena Chemello
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.
| | - Marialuisa Gandolfi
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy.
| | - Angela Modenese
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy.
| | - Alessandro Picelli
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy.
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28
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Facchin A, Sartori E, Luisetti C, De Galeazzi A, Beschin N. Effect of prism adaptation on neglect hemianesthesia. Cortex 2019; 113:298-311. [PMID: 30716611 DOI: 10.1016/j.cortex.2018.12.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 09/07/2018] [Accepted: 12/21/2018] [Indexed: 11/20/2022]
Abstract
Prism adaptation (PA) has proven to be effective in alleviating many signs of unilateral spatial neglect (USN). Generally, the principal improvement after PA treatment was found to be in the high-level cognitive function. Nevertheless, some evidence has also been found for it in somatosensory function. We have aimed to test the influence of PA on neglect hemianesthesia, a condition in which the high-level neglect-related deficit mimics hemianesthesia. Twenty-one USN patients were enrolled in the study. Each patient performed two sessions of PA, one with neutral glasses and one with prism glasses using a cross-over design. Sensitivity on the upper limb was tested using two methods. The first task was the sensibility subtest which was derived from the standard clinical examination. The second was the perceptual and motor electro-cutaneous threshold on the forearms using an electro-cutaneous stimulator. Four neuropsychological tests were used to diagnose USN and to check improvement: Star cancellation, Line bisection, Sentence reading and the Comb & Razor test. Comparing prism with sham conditions, our results show significant improvements in double extinction and in the electro-cutaneous perceptual threshold only for the contralesional hand. No improvement was found for the ipsilesional hand, for the motor threshold, and for neutral glasses. Significant improvement was found in personal neglect. Replication of the task in a subgroup of patients confirmed the primary results. The improvements in somatosensory perception together with the amelioration of personal neglect suggest that PA also has a specific effect on the neglect hemianesthesia.
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Affiliation(s)
- Alessio Facchin
- Department of Psychology, University of Milano-Bicocca, Milano, Italy; Milan Centre for Neuroscience, Milano, Italy; Centre for Research in Optics and Optometry, University of Milano-Bicocca (COMIB), Milano, Italy; Institute of Research and Studies in Optics and Optometry, Vinci, Italy.
| | - Elena Sartori
- Rehabilitation Department, A.S.S.T. Valle Olona, Varese, Italy
| | - Chiara Luisetti
- Rehabilitation Department, A.S.S.T. Valle Olona, Varese, Italy
| | | | - Nicoletta Beschin
- Neuropsychological Service, Rehabilitation Department, A.S.S.T. Valle Olona, Varese, Italy
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29
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Huygelier H, Gillebert CR. Quantifying egocentric spatial neglect with cancellation tasks: A theoretical validation. J Neuropsychol 2018; 14:1-19. [DOI: 10.1111/jnp.12177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 10/25/2018] [Indexed: 12/16/2022]
Affiliation(s)
| | - Céline R. Gillebert
- Department of Brain and Cognition KU Leuven Belgium
- Department of Experimental Psychology University of Oxford UK
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30
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Abstract
A review of patients with brain injury showing personal neglect is presented. The aim is to shed light on this aspect of neglect often unresearched or only indirectly investigated, and to discuss recent findings concerning the methods used to assess personal neglect, its neural correlates and its association with the more often explored aspect of extrapersonal neglect. The review was performed using PubMed and PsychInfo databases to search for papers published in the last 123 years (until January 2018). We reviewed 81 papers describing either single or group studies for a total of 2247 patients. The results of this review showed that various aspects of personal neglect are still controversial and outcomes potentially contradictory. Despite the data reported in the present review suggest that personal neglect is more frequently associated with lesions of the right hemisphere, the left hemisphere may also play an important role. Not surprisingly, personal neglect and extrapersonal neglect seem to co-occur. However double dissociations of these two forms of neglect have been reported, and they seem to dissociate both from a functional and an anatomical perspective. More recent interpretations of personal neglect suggest that it may result from a disrupted body representation. The development of reliable psychometric tools with shared diagnostic criteria is essential to identify different degrees of personal neglect for different body parts and to better refine personal neglect in comparison to extrapersonal neglect and disorders related to distortions of personal domain.
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Affiliation(s)
- Pietro Caggiano
- Psychology Department, Goldsmiths University of London, New Cross, London, SE14 6NW, UK.
| | - Mervi Jehkonen
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
- Department of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Finland
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31
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Facchin A, Bultitude JH, Mornati G, Peverelli M, Daini R. A comparison of prism adaptation with terminal versus concurrent exposure on sensorimotor changes and spatial neglect. Neuropsychol Rehabil 2018; 30:613-640. [DOI: 10.1080/09602011.2018.1484374] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Alessio Facchin
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
- Milan Centre for Neuroscience, Milano, Italy
- Centre of Research in Optics and Optometry, University of Milano-Bicocca (COMiB), Milano, Italy
- Institute of Research and Studies in Optics and Optometry, Vinci, Italy
| | | | - Giulia Mornati
- Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Milena Peverelli
- Valduce Hospital Rehabilitation Center Villa Beretta, Costamasnaga, Italy
| | - Roberta Daini
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
- Milan Centre for Neuroscience, Milano, Italy
- Centre of Research in Optics and Optometry, University of Milano-Bicocca (COMiB), Milano, Italy
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32
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Modulating anosognosia for hemiplegia: The role of dangerous actions in emergent awareness. Cortex 2017; 92:187-203. [DOI: 10.1016/j.cortex.2017.04.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/14/2017] [Accepted: 04/12/2017] [Indexed: 11/22/2022]
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33
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Kirsch LP, Krahé C, Blom N, Crucianelli L, Moro V, Jenkinson PM, Fotopoulou A. Reading the mind in the touch: Neurophysiological specificity in the communication of emotions by touch. Neuropsychologia 2017; 116:136-149. [PMID: 28572007 PMCID: PMC6078710 DOI: 10.1016/j.neuropsychologia.2017.05.024] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/02/2017] [Accepted: 05/24/2017] [Indexed: 12/24/2022]
Abstract
Touch is central to interpersonal interactions. Touch conveys specific emotions about the touch provider, but it is not clear whether this is a purely socially learned function or whether it has neurophysiological specificity. In two experiments with healthy participants (N = 76 and 61) and one neuropsychological single case study, we investigated whether a type of touch characterised by peripheral and central neurophysiological specificity, namely the C tactile (CT) system, can communicate specific emotions and mental states. We examined the specificity of emotions elicited by touch delivered at CT-optimal (3 cm/s) and CT-suboptimal (18 cm/s) velocities (Experiment 1) at different body sites which contain (forearm) vs. do not contain (palm of the hand) CT fibres (Experiment 2). Blindfolded participants were touched without any contextual cues, and were asked to identify the touch provider's emotion and intention. Overall, CT-optimal touch (slow, gentle touch on the forearm) was significantly more likely than other types of touch to convey arousal, lust or desire. Affiliative emotions such as love and related intentions such as social support were instead reliably elicited by gentle touch, irrespective of CT-optimality, suggesting that other top-down factors contribute to these aspects of tactile social communication. To explore the neural basis of this communication, we also tested this paradigm in a stroke patient with right perisylvian damage, including the posterior insular cortex, which is considered as the primary cortical target of CT afferents, but excluding temporal cortex involvement that has been linked to more affiliative aspects of CT-optimal touch. His performance suggested an impairment in ‘reading’ emotions based on CT-optimal touch. Taken together, our results suggest that the CT system can add specificity to emotional and social communication, particularly with regards to feelings of desire and arousal. On the basis of these findings, we speculate that its primary functional role may be to enhance the ‘sensual salience’ of tactile interactions. Touch can convey specific emotions and intentions. Slow gentle touch communicates love and intimacy regardless of CT fibre activation. The CT system plays a specific role in mediating sensual touch. Insula activation might be necessary in the arousing function of the CT system.
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Affiliation(s)
- Louise P Kirsch
- Department of Clinical, Educational and Health Psychology, University College London, UK.
| | - Charlotte Krahé
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nadia Blom
- Department of Psychology, School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Laura Crucianelli
- Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Valentina Moro
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Italy
| | - Paul M Jenkinson
- Department of Psychology, School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Aikaterini Fotopoulou
- Department of Clinical, Educational and Health Psychology, University College London, UK
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Magnani FG, Sedda A. Paying the price for body evolution: The role of evolution in disorders of body representation. Med Hypotheses 2016; 98:81-86. [PMID: 28012612 DOI: 10.1016/j.mehy.2016.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 11/22/2016] [Indexed: 11/29/2022]
Abstract
Since its beginning, research about cognitive representation of our bodies has debated over multiple representations models. Furthermore, recent years have seen a rise in the study of body representation disorders and related impairments. However, why human beings manifest so many deficits is still a mystery. Considering human evolution, frontal brain regions are well known for their changes in dimensions and connections. Less known is that parietal and temporal lobes encountered similar changes. These areas, especially in the right hemisphere, are crucial for body representation. Our hypothesis is that evolution of these areas determined a more varied and widespread cross wiring between the temporal and parietal lobes, increasing their communication pathways and their reciprocal influence. As such, these connections could lead to an increased probability of interconnected body and emotional disorders in humans. The prediction of this hypothesis is that all body representation disorders have an associated emotional component and vice versa. Evidence supporting the interconnection between emotional and body representation disorders derives from psychiatric diseases such as eating disorders. This hypothesis opens up new directions to understand body representation and points towards innovative solutions for the clinical treatments of body representation/emotional impairments.
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Affiliation(s)
- Francesca G Magnani
- Psychology, School of Social Sciences, Heriot Watt University, Edinburgh Campus, UK; Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Anna Sedda
- Psychology, School of Social Sciences, Heriot Watt University, Edinburgh Campus, UK.
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35
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Martinaud O, Besharati S, Jenkinson PM, Fotopoulou A. Ownership illusions in patients with body delusions: Different neural profiles of visual capture and disownership. Cortex 2016; 87:174-185. [PMID: 27839786 PMCID: PMC5312675 DOI: 10.1016/j.cortex.2016.09.025] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 07/22/2016] [Accepted: 09/25/2016] [Indexed: 12/01/2022]
Abstract
The various neurocognitive processes contributing to the sense of body ownership have been investigated extensively in healthy participants, but studies in neurological patients can shed unique light into such phenomena. Here, we aimed to investigate whether visual capture by a fake hand (without any synchronous or asynchronous tactile stimulation) affects body ownership in a group of hemiplegic patients with or without disturbed sensation of limb ownership (DSO) following damage to the right hemisphere. We recruited 31 consecutive patients, including seven patients with DSO. The majority of our patients (64.5% overall and up to 86% of the patients with DSO) experienced strong feelings of ownership over a rubber hand within 15 sec following mere visual exposure, which correlated with the degree of proprioceptive deficits across groups and in the DSO group. Using voxel-based lesion-symptom mapping analysis, we were able to identify lesions associated with this pathological visual capture effect in a selective fronto-parietal network, including significant voxels (p < .05) in the frontal operculum and the inferior frontal gyrus. By contrast, lesions associated with DSO involved more posterior lesions, including the right temporoparietal junction and a large area of the supramarginal gyrus, and to a lesser degree the middle frontal gyrus. Thus, this study suggests that our sense of ownership includes dissociable mechanisms of multisensory integration.
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Affiliation(s)
- Olivier Martinaud
- Department of Neurology, Rouen University Hospital, France; Clinical, Educational & Health Psychology Research Department, Division of Psychology & Language Sciences, University College London, UK
| | - Sahba Besharati
- Clinical, Educational & Health Psychology Research Department, Division of Psychology & Language Sciences, University College London, UK; Academic Unit of Neuropsychiatry, King's College London, UK
| | - Paul M Jenkinson
- School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Aikaterini Fotopoulou
- Clinical, Educational & Health Psychology Research Department, Division of Psychology & Language Sciences, University College London, UK.
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36
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Moro V, Pernigo S, Tsakiris M, Avesani R, Edelstyn NM, Jenkinson PM, Fotopoulou A. Motor versus body awareness: Voxel-based lesion analysis in anosognosia for hemiplegia and somatoparaphrenia following right hemisphere stroke. Cortex 2016; 83:62-77. [DOI: 10.1016/j.cortex.2016.07.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 05/06/2016] [Accepted: 07/06/2016] [Indexed: 01/01/2023]
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37
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Facchin A, Beschin N, Pisano A, Reverberi C. Normative data for distal line bisection and baking tray task. Neurol Sci 2016; 37:1531-6. [DOI: 10.1007/s10072-016-2626-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/28/2016] [Indexed: 11/30/2022]
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38
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Di Vita A, Palermo L, Piccardi L, Di Tella J, Propato F, Guariglia C. Body representation alterations in personal but not in extrapersonal neglect patients. APPLIED NEUROPSYCHOLOGY-ADULT 2016; 24:308-317. [DOI: 10.1080/23279095.2016.1174866] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Antonella Di Vita
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia of Rome, Rome, Italy
| | - Liana Palermo
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia of Rome, Rome, Italy
- Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, Italy
- School of Life & Health Sciences, Aston University, Birmingham, UK
| | - Laura Piccardi
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia of Rome, Rome, Italy
- Department of Life, Health and Environmental Sciences, L'Aquila University, L'Aquila, Italy
| | - Jessica Di Tella
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Filomena Propato
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Cecilia Guariglia
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia of Rome, Rome, Italy
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Champod AS, Frank RC, Taylor K, Eskes GA. The effects of prism adaptation on daily life activities in patients with visuospatial neglect: a systematic review. Neuropsychol Rehabil 2016; 28:491-514. [DOI: 10.1080/09602011.2016.1182032] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Anne Sophie Champod
- Department of Psychology, Acadia University, Wolfville, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Rachel C. Frank
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Kristina Taylor
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Gail A. Eskes
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- Department of Psychology, Dalhousie University, Halifax, Canada
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Besharati S, Forkel SJ, Kopelman M, Solms M, Jenkinson PM, Fotopoulou A. Mentalizing the body: spatial and social cognition in anosognosia for hemiplegia. Brain 2016; 139:971-85. [PMID: 26811254 PMCID: PMC4766377 DOI: 10.1093/brain/awv390] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 10/12/2015] [Accepted: 11/12/2015] [Indexed: 11/24/2022] Open
Abstract
Following right-hemisphere damage, a specific disorder of motor awareness can occur called anosognosia for hemiplegia, i.e. the denial of motor deficits contralateral to a brain lesion. The study of anosognosia can offer unique insights into the neurocognitive basis of awareness. Typically, however, awareness is assessed as a first person judgement and the ability of patients to think about their bodies in more 'objective' (third person) terms is not directly assessed. This may be important as right-hemisphere spatial abilities may underlie our ability to take third person perspectives. This possibility was assessed for the first time in the present study. We investigated third person perspective taking using both visuospatial and verbal tasks in right-hemisphere stroke patients with anosognosia (n = 15) and without anosognosia (n = 15), as well as neurologically healthy control subjects (n = 15). The anosognosic group performed worse than both control groups when having to perform the tasks from a third versus a first person perspective. Individual analysis further revealed a classical dissociation between most anosognosic patients and control subjects in mental (but not visuospatial) third person perspective taking abilities. Finally, the severity of unawareness in anosognosia patients was correlated to greater impairments in such third person, mental perspective taking abilities (but not visuospatial perspective taking). In voxel-based lesion mapping we also identified the lesion sites linked with such deficits, including some brain areas previously associated with inhibition, perspective taking and mentalizing, such as the inferior and middle frontal gyri, as well as the supramarginal and superior temporal gyri. These results suggest that neurocognitive deficits in mental perspective taking may contribute to anosognosia and provide novel insights regarding the relation between self-awareness and social cognition.
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Affiliation(s)
- Sahba Besharati
- 1 Department of Psychology, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, UK 2 Department of Psychology, University of Cape Town, South Africa 3 Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, UK
| | - Stephanie J Forkel
- 3 Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, UK 4 Natbrainlab, Department of Neuroimaging, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Michael Kopelman
- 5 Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, UK
| | - Mark Solms
- 2 Department of Psychology, University of Cape Town, South Africa
| | - Paul M Jenkinson
- 6 Department of Psychology, School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Aikaterini Fotopoulou
- 3 Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, UK
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41
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Besharati S, Forkel SJ, Kopelman M, Solms M, Jenkinson PM, Fotopoulou A. The affective modulation of motor awareness in anosognosia for hemiplegia: behavioural and lesion evidence. Cortex 2015; 61:127-40. [PMID: 25481471 PMCID: PMC4296216 DOI: 10.1016/j.cortex.2014.08.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 06/16/2014] [Accepted: 08/03/2014] [Indexed: 11/09/2022]
Abstract
The possible role of emotion in anosognosia for hemiplegia (i.e., denial of motor deficits contralateral to a brain lesion), has long been debated between psychodynamic and neurocognitive theories. However, there are only a handful of case studies focussing on this topic, and the precise role of emotion in anosognosia for hemiplegia requires empirical investigation. In the present study, we aimed to investigate how negative and positive emotions influence motor awareness in anosognosia. Positive and negative emotions were induced under carefully-controlled experimental conditions in right-hemisphere stroke patients with anosognosia for hemiplegia (n = 11) and controls with clinically normal awareness (n = 10). Only the negative, emotion induction condition resulted in a significant improvement of motor awareness in anosognosic patients compared to controls; the positive emotion induction did not. Using lesion overlay and voxel-based lesion-symptom mapping approaches, we also investigated the brain lesions associated with the diagnosis of anosognosia, as well as with performance on the experimental task. Anatomical areas that are commonly damaged in AHP included the right-hemisphere motor and sensory cortices, the inferior frontal cortex, and the insula. Additionally, the insula, putamen and anterior periventricular white matter were associated with less awareness change following the negative emotion induction. This study suggests that motor unawareness and the observed lack of negative emotions about one's disabilities cannot be adequately explained by either purely motivational or neurocognitive accounts. Instead, we propose an integrative account in which insular and striatal lesions result in weak interoceptive and motivational signals. These deficits lead to faulty inferences about the self, involving a difficulty to personalise new sensorimotor information, and an abnormal adherence to premorbid beliefs about the body.
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Affiliation(s)
- Sahba Besharati
- King's College London, Institute of Psychiatry, UK; Department of Psychology, University of Cape Town, South Africa; Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, University College London, UK.
| | - Stephanie J Forkel
- Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, University College London, UK; King's College London, Department of Neuroimaging, Natbrainlab, Institute of Psychiatry, UK
| | | | - Mark Solms
- Department of Psychology, University of Cape Town, South Africa
| | - Paul M Jenkinson
- Department of Psychology, School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Aikaterini Fotopoulou
- Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, University College London, UK.
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42
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Selective improvement of anosognosia for hemiplegia during transcranial direct current stimulation: a case report. Cortex 2015; 61:107-19. [PMID: 25481469 DOI: 10.1016/j.cortex.2014.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 06/17/2014] [Accepted: 08/07/2014] [Indexed: 11/21/2022]
Abstract
Right brain damage patients may not complain of a left sided paralysis up to the point of denying it or even claiming of having just moved an otherwise paralyzed limb. This condition is known as anosognosia for hemiplegia (AHP). Recent behavioural experiments suggest that some residual intentionality might be preserved in patients with anosognosia and that the false belief of having moved originates from a failure to notice discrepancies between movement expectancies and the actual state of the motor system. This failure may be caused by a lack of afferent sensory information concerning the movement or alternatively by a direct dysfunction of the brain regions involved in actions' motor monitoring (i.e., the comparator system). Here we examined the effect of anodal transcranial direct current stimulation (tDCS) of the right premotor cortex in a patient with a bilateral lesion, involving predominantly the right hemisphere, and a dense unawareness for his left hemiplegia. During sham or anodal tDCS the patient was requested to judge his ability to perform simple motor actions (i) without actually executing the movement itself ("offline" condition) and after having performed a series of verbally cued finger opposition movements ("online" condition) with (i) eyes-closed or (ii) eyes-open. We found that anodal tDCS induces a significant remission of the false experience of movement only when the patient is requested to actually perform the movement with eyes open. Conversely, the patient's awareness does not improve in both the "offline" condition (in which the patient does not attempt to perform the movement) and in the "online" condition, when vision is precluded ("online" condition, eyes-closed). We conclude that the stimulation of the premotor cortex by tDCS activates brain regions involved in motor monitoring, temporary restoring the ability of the motor comparator system to correctly appreciate afferent information and build up a veridical motor awareness.
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Abstract
The syndrome of visuospatial neglect is a common consequence of unilateral brain injury. It is most often associated with stroke and is more severe and persistent following right hemisphere damage, with reported frequencies in the acute stage of up to 80%. Neglect is primarily a disorder of attention whereby patients characteristically fail to orientate, to report or to respond to stimuli located on the contralesional side. Neglect is usually caused by large strokes in the middle cerebral artery territory and is heterogeneous, such that most patients do not manifest every feature of the syndrome. A number of treatments may improve neglect, but there is no widely accepted universal approach to therapy. Although most patients recover spontaneously, the evidence suggests that they continue to have significant cognitive impairments, particularly relating to attention.
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Affiliation(s)
- Korina Li
- Centre for Restorative Neuroscience, Division of Brain Sciences, Imperial College London, London, UK Department of Neurology, University Hospital Coventry, Coventry, West Midlands, UK
| | - Paresh A Malhotra
- Centre for Restorative Neuroscience, Division of Brain Sciences, Imperial College London, London, UK
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Jenkinson PM, Edelstyn NMJ, Preston C, Ellis SJ. Anarchic hand with abnormal agency following right inferior parietal lobe damage: a case report. Neurocase 2015; 21:471-8. [PMID: 24898941 DOI: 10.1080/13554794.2014.925936] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Anarchic hand syndrome (AHS) is characterized by goal-directed movements performed without volitional control (agency). Different AHS subtypes have been identified; however, few studies have examined the posterior subtype. We report a case of AHS following right-hemisphere parietal damage, with left-sided somatosensory and proprioceptive impairment. Agency was examined for nonanarchic (volitional) movements performed using the anarchic hand. The patient experienced abnormal agency for movements whether motor intention and visual feedback were congruent or incongruent, but not when intention was absent (passive movement). Findings suggest a general disturbance of veridical motor awareness and agency in this case of parietal AHS.
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Affiliation(s)
- Paul M Jenkinson
- a Department of Psychology , University of Hertfordshire , Hertfordshire , UK
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45
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Moro V, Scandola M, Bulgarelli C, Avesani R, Fotopoulou A. Error-based training and emergent awareness in anosognosia for hemiplegia. Neuropsychol Rehabil 2014; 25:593-616. [DOI: 10.1080/09602011.2014.951659] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Besharati S, Kopelman M, Avesani R, Moro V, Fotopoulou A(K. Another perspective on anosognosia: Self-observation in video replay improves motor awareness. Neuropsychol Rehabil 2014; 25:319-52. [DOI: 10.1080/09602011.2014.923319] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Priftis K, Passarini L, Pilosio C, Meneghello F, Pitteri M. Visual Scanning Training, Limb Activation Treatment, and Prism Adaptation for Rehabilitating Left Neglect: Who is the Winner? Front Hum Neurosci 2013; 7:360. [PMID: 23847520 PMCID: PMC3703546 DOI: 10.3389/fnhum.2013.00360] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 06/22/2013] [Indexed: 12/02/2022] Open
Abstract
WE COMPARED, FOR THE FIRST TIME, THE OVERALL AND DIFFERENTIAL EFFECTS OF THREE OF THE MOST WIDELY USED LEFT NEGLECT (LN) TREATMENTS: visual scanning training (VST), limb activation treatment (LAT), and prism adaptation (PA). Thirty-three LN patients were assigned in quasi-random order to the three groups (VST, LAT, or PA). Each patient received only one type of treatment. LN patients' performance on everyday life tasks was assessed four times (over a period of 6 weeks): A1 and A2 (i.e., the two pre-treatment assessments); A3 and A4 (i.e., the two post-treatment assessments). LN patients in each of the three treatment conditions were treated for the same number of sessions (i.e., 20). The results showed that improvements were present in the majority of the tests assessing the peripersonal space in everyday life activities. Our findings were independent of unspecific factors and lasted for at least 2 weeks following the end of the treatments. There were no interactions, however, between LN treatments and assessments. We suggest that all three treatments can be considered as valid rehabilitation interventions for LN and could be employed for ameliorating LN signs.
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Affiliation(s)
- Konstantinos Priftis
- Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy
- Department of General Psychology, University of Padova, Padova, Italy
| | - Laura Passarini
- Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy
| | - Cristina Pilosio
- Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy
| | | | - Marco Pitteri
- Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy
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Reinhart S, Schmidt L, Kuhn C, Rosenthal A, Schenk T, Keller I, Kerkhoff G. Limb activation ameliorates body-related deficits in spatial neglect. Front Hum Neurosci 2012; 6:188. [PMID: 22737118 PMCID: PMC3381448 DOI: 10.3389/fnhum.2012.00188] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 06/07/2012] [Indexed: 11/13/2022] Open
Abstract
Many neglect patients show deficits in the mental representation of their contralesional body side or body parts, termed personal neglect. These deficits include impairments in identifying body parts on schematic drawings of human bodies. Limb activation and alertness cues have been shown to modulate neglect transiently, and are effective treatments for several symptoms of the neglect syndrome. Here, we tested on eight patients with right-hemispheric stroke and left-sided spatial neglect whether these two techniques modulate deficits in the mental representation of hands, assessed with a hand-test in which the subjects had to decide whether a depicted schematic hand belongs to the left or right side of the human body. The results showed that neglect patients made marginally significant (p = 0.065) more errors in left-hand-decisions than right-hand-decisions, indicating a neglect-specific disorder. Moreover, we found that left-sided limb activation but not non-lateralized alertness cueing (a loud noise immediately before patients made their perceptual decision) significantly reduced misidentifications for depicted left hands as compared to baseline. No effect of any intervention was observed on error rates for depicted right hands. We conclude that the amelioration of the performance in the hand task is modulated by the activation of the body schema or other body representations through left-sided limb activation.
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Affiliation(s)
- S Reinhart
- Clinical Neuropsychology Unit and Outpatient Service, Saarland University Saarbruecken, Germany
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Rusconi ML, Carelli L. Long-term efficacy of prism adaptation on spatial neglect: preliminary results on different spatial components. ScientificWorldJournal 2012; 2012:618528. [PMID: 22629167 PMCID: PMC3354535 DOI: 10.1100/2012/618528] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 12/18/2011] [Indexed: 11/17/2022] Open
Abstract
This study describes the long-term effectiveness on spatial neglect recovery of a 2-week treatment based on prism adaptation (PA). Seven right-brain-damaged patients affected by chronic neglect were evaluated before, after two weeks of the PA treatment and at a follow-up (variable between 8 and 30 months after the end of PA). Neglect evaluation was performed by means of BIT (conventional and behavioral), Fluff Test, and Comb and Razor Test. The results highlight an improvement, after the PA training, in both tasks performed using the hand trained in PA treatment and in behavioral tasks not requiring a manual motor response. Such effects extend, even if not significantly, to all BIT subtests. These results support previous findings, showing that PA improves neglect also on imagery tasks with no manual component, and provide further evidence for long-lasting efficacy of PA training. Dissociations have been found with regard to PA efficacy on peripersonal, personal, and representational neglect, visuospatial agraphia and neglect dyslexia. In particular, we found no significant differences between the pre-training and post-training PA session in personal neglect measures, and a poor recovery of neglect dyslexia after PA treatment. The recruitment of a larger sample could help to confirm the effectiveness of the prismatic lenses with regard to the different clinical manifestations of spatial neglect.
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