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Fattorini L, Rodio A, Filippi GM, Pettorossi VE. Effectiveness of Focal Muscle Vibration in the Recovery of Neuromotor Hypofunction: A Systematic Review. J Funct Morphol Kinesiol 2023; 8:103. [PMID: 37606398 PMCID: PMC10443241 DOI: 10.3390/jfmk8030103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
Adequate physical recovery after trauma, injury, disease, a long period of hypomobility, or simply ageing is a difficult goal because rehabilitation protocols are long-lasting and often cannot ensure complete motor recovery. Therefore, the optimisation of rehabilitation procedures is an important target to be achieved. The possibility of restoring motor functions by acting on proprioceptive signals by unspecific repetitive muscle vibration, focally applied on single muscles (RFV), instead of only training muscle function, is a new perspective, as suggested by the effects on the motor performance evidenced by healthy persons. The focal muscle vibration consists of micro-stretching-shortening sequences applied to individual muscles. By repeating such stimulation, an immediate and persistent increase in motility can be attained. This review aims to show whether this proprioceptive stimulation is useful for optimising the rehabilitative process in the presence of poor motor function. Papers reporting RFV effects have evidenced that the motor deficits can be counteracted by focal vibration leading to an early and quick complete recovery. The RFV efficacy has been observed in various clinical conditions. The motor improvements were immediate and obtained without loading the joints. The review suggests that these protocols can be considered a powerful new advantage to enhance traditional rehabilitation and achieve a more complete motor recovery.
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Affiliation(s)
- Luigi Fattorini
- Department of Physiology and Pharmacology “V. Erspamer”, School of Medicine, Faculty of Medicine and Surgery, Sapienza Università di Roma, L.go A. Moro 5, 00185 Rome, Italy;
| | - Angelo Rodio
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Loc. Folcara, 03043 Cassino, Italy
| | - Guido Maria Filippi
- Department of Neuroscience, School of Medicine, Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Vito Enrico Pettorossi
- Department of Medicine and Surgery, Human Physiology Section, Università degli Studi di Perugia, Piazzale Gambuli 1, 06129 Perugia, Italy;
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2
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Millot S, Beis JM, Pierret J, Badin M, Sabau V, Bensoussan L, Paysant J, Ceyte H. Innovative Therapy Combining Neck Muscle Vibration and Transcranial Direct Current Stimulation in Association with Conventional Rehabilitation in Left Unilateral Spatial Neglect Patients: HEMISTIM Protocol for a Randomized Controlled Trial. Brain Sci 2023; 13:brainsci13040678. [PMID: 37190643 DOI: 10.3390/brainsci13040678] [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: 03/26/2023] [Revised: 04/15/2023] [Accepted: 04/16/2023] [Indexed: 05/17/2023] Open
Abstract
Unilateral spatial neglect (USN) rehabilitation requires the development of new methods that can be easily integrated into conventional practice. The aim of the HEMISTIM protocol is to assess immediate and long-term recovery induced by an innovative association of left-side neck-muscle vibration (NMV) and anodal transcranial Direct Current Stimulation (tDCS) on the ipsilesional posterior parietal cortex during occupational therapy sessions in patients with left USN. Participants will be randomly assigned to four groups: control, Left-NMV, Left-NMV + sham-tDCS or Left-NMV + anodal-tDCS. NMV and tDCS will be applied during the first 15 min of occupational therapy sessions, three days a week for three weeks. USN will be assessed at baseline, just at the end of the first experimental session, after the first and third weeks of the protocol and three weeks after its ending. Our primary outcome will be the evolution of the functional Catherine Bergego Scale score. Secondary outcome measures include five tests that investigate different neuropsychological aspects of USN. Left NMV, by activating multisensory integration neuronal networks, might enhance effects obtained by conventional therapy since post-effects were shown when it was combined with upper limb movements. We expect to reinforce lasting intermodal recalibration through LTP-like plasticity induced by anodal tDCS.
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Affiliation(s)
- Sarah Millot
- UGECAM Nord-Est, Institut Régional de Médecine Physique et de Réadaptation, Centre de Médecine Physique et de Réadaptation, Lay Saint-Christophe, France
- Université de Lorraine, DevAH, Nancy, France
| | - Jean-Marie Beis
- UGECAM Nord-Est, Institut Régional de Médecine Physique et de Réadaptation, Centre de Médecine Physique et de Réadaptation, Lay Saint-Christophe, France
- Université de Lorraine, DevAH, Nancy, France
| | - Jonathan Pierret
- UGECAM Nord-Est, Institut Régional de Médecine Physique et de Réadaptation, Centre de Médecine Physique et de Réadaptation, Lay Saint-Christophe, France
- Université de Lorraine, DevAH, Nancy, France
| | - Marina Badin
- UGECAM Nord-Est, Institut Régional de Médecine Physique et de Réadaptation, Centre de Médecine Physique et de Réadaptation, Lay Saint-Christophe, France
| | - Verginia Sabau
- UGECAM PACA-Corse, Centre Helio Marin, Vallauris, France
| | - Laurent Bensoussan
- Aix Marseille Univ, CNRS, INT, Marseille, France
- UGECAM PACA, Institut Universitaire de Réadaptation de Valmante Sud, Marseille, France
| | - Jean Paysant
- UGECAM Nord-Est, Institut Régional de Médecine Physique et de Réadaptation, Centre de Médecine Physique et de Réadaptation, Lay Saint-Christophe, France
- Université de Lorraine, DevAH, Nancy, France
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Filippi GM, Rodio A, Fattorini L, Faralli M, Ricci G, Pettorossi VE. Plastic changes induced by muscle focal vibration: A possible mechanism for long-term motor improvements. Front Neurosci 2023; 17:1112232. [PMID: 36908788 PMCID: PMC9992721 DOI: 10.3389/fnins.2023.1112232] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Repetitive focal vibrations can induce positive and persistent after-effects. There is still no satisfactory interpretation of the underlying mechanisms. A rationale, which can provide consistency among different results, is highly desirable to guide both the use of the application and future research. To date, interpretive models are formulated to justify the results, depending on the specific protocol adopted. Indeed, protocol parameters, such as stimulus intensity and frequency, intervention time and administration period, are variable among different studies. However, in this article, we have identified features of the protocols that may allow us to suggest a possible common mechanism underlying the effectiveness of focal vibration under different physiologic and pathologic conditions. Since repetitive focal muscle vibration induces powerful and prolonged activation of muscle proprioceptors, we hypothesize that this intense activation generates adaptive synaptic changes along sensory and motor circuits. This may lead to long-term synaptic potentiation in the central network, inducing an enhancement of the learning capability. The plastic event could increase proprioceptive discriminative ability and accuracy of the spatial reference frame and, consequently, improve motor planning and execution for different motor functions and in the presence of different motor dysfunctions. The proposed mechanism may explain the surprising and sometimes particularly rapid improvements in motor execution in healthy and diseased individuals, regardless of specific physical training. This hypothetic mechanism may require experimental evidence and could lead to extend and adapt the application of the "learning without training" paradigms to other functional and recovery needs.
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Affiliation(s)
- Guido M Filippi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.,Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angelo Rodio
- Department of Human Sciences, Society, and Health, University of Cassino and Southern Lazio, Frosinone, Italy
| | - Luigi Fattorini
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza Università di Roma, Rome, Italy
| | - Mario Faralli
- Department of Medicine and Surgery, Otorhinolaryngology Section, Università degli Studi di Perugia, Perugia, Italy
| | - Giampietro Ricci
- Department of Medicine and Surgery, Otorhinolaryngology Section, Università degli Studi di Perugia, Perugia, Italy
| | - Vito E Pettorossi
- Department of Medicine and Surgery, Human Physiology Section, Università degli Studi di Perugia, Perugia, Italy
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Knobel SEJ, Kaufmann BC, Geiser N, Gerber SM, Müri RM, Nef T, Nyffeler T, Cazzoli D. Effects of Virtual Reality-Based Multimodal Audio-Tactile Cueing in Patients With Spatial Attention Deficits: Pilot Usability Study. JMIR Serious Games 2022; 10:e34884. [PMID: 35612894 PMCID: PMC9178455 DOI: 10.2196/34884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/17/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Virtual reality (VR) devices are increasingly being used in medicine and other areas for a broad spectrum of applications. One of the possible applications of VR involves the creation of an environment manipulated in a way that helps patients with disturbances in the spatial allocation of visual attention (so-called hemispatial neglect). One approach to ameliorate neglect is to apply cross-modal cues (ie, cues in sensory modalities other than the visual one, eg, auditory and tactile) to guide visual attention toward the neglected space. So far, no study has investigated the effects of audio-tactile cues in VR on the spatial deployment of visual attention in neglect patients. OBJECTIVE This pilot study aimed to investigate the feasibility and usability of multimodal (audio-tactile) cueing, as implemented in a 3D VR setting, in patients with neglect, and obtain preliminary results concerning the effects of different types of cues on visual attention allocation compared with noncued conditions. METHODS Patients were placed in a virtual environment using a head-mounted display (HMD). The inlay of the HMD was equipped to deliver tactile feedback to the forehead. The task was to find and flag appearing birds. The birds could appear at 4 different presentation angles (lateral and paracentral on the left and right sides), and with (auditory, tactile, or audio-tactile cue) or without (no cue) a spatially meaningful cue. The task usability and feasibility, and 2 simple in-task measures (performance and early orientation) were assessed in 12 right-hemispheric stroke patients with neglect (5 with and 7 without additional somatosensory impairment). RESULTS The new VR setup showed high usability (mean score 10.2, SD 1.85; maximum score 12) and no relevant side effects (mean score 0.833, SD 0.834; maximum score 21). A repeated measures ANOVA on task performance data, with presentation angle, cue type, and group as factors, revealed a significant main effect of cue type (F30,3=9.863; P<.001) and a significant 3-way interaction (F90,9=2.057; P=.04). Post-hoc analyses revealed that among patients without somatosensory impairment, any cue led to better performance compared with no cue, for targets on the left side, and audio-tactile cues did not seem to have additive effects. Among patients with somatosensory impairment, performance was better with both auditory and audio-tactile cueing than with no cue, at every presentation angle; conversely, tactile cueing alone had no significant effect at any presentation angle. Analysis of early orientation data showed that any type of cue triggered better orientation in both groups for lateral presentation angles, possibly reflecting an early alerting effect. CONCLUSIONS Overall, audio-tactile cueing seems to be a promising method to guide patient attention. For instance, in the future, it could be used as an add-on method that supports attentional orientation during established therapeutic approaches.
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Affiliation(s)
| | - Brigitte Charlotte Kaufmann
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute (ICM), Inserm, Centre national de la recherche scientifique, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Nora Geiser
- Neurocenter, Luzerner Kantonsspital, Luzern, Switzerland
| | | | - René M Müri
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tobias Nef
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Thomas Nyffeler
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,Neurocenter, Luzerner Kantonsspital, Luzern, Switzerland.,Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Dario Cazzoli
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,Neurocenter, Luzerner Kantonsspital, Luzern, Switzerland.,Institute of Psychology, University of Bern, Bern, Switzerland
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Felisatti A, Ranzini M, Blini E, Lisi M, Zorzi M. Effects of attentional shifts along the vertical axis on number processing: An eye-tracking study with optokinetic stimulation. Cognition 2021; 221:104991. [PMID: 34968993 DOI: 10.1016/j.cognition.2021.104991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 11/06/2021] [Accepted: 12/10/2021] [Indexed: 11/25/2022]
Abstract
Previous studies suggest that associations between numbers and space are mediated by shifts of visuospatial attention along the horizontal axis. In this study, we investigated the effect of vertical shifts of overt attention, induced by optokinetic stimulation (OKS) and monitored through eye-tracking, in two tasks requiring explicit (number comparison) or implicit (parity judgment) processing of number magnitude. Participants were exposed to black-and-white stripes (OKS) that moved vertically (upward or downward) or remained static (control condition). During the OKS, participants were asked to verbally classify auditory one-digit numbers as larger/smaller than 5 (comparison task; Exp. 1) or as odd/even (parity task; Exp. 2). OKS modulated response times in both experiments. In Exp.1, upward attentional displacement decreased the Magnitude effect (slower responses for large numbers) and increased the Distance effect (slower responses for numbers close to the reference). In Exp.2, we observed a complex interaction between parity, magnitude, and OKS, indicating that downward attentional displacement slowed down responses for large odd numbers. Moreover, eye tracking analyses revealed an influence of number processing on eye movements both in Exp. 1, with eye gaze shifting downwards during the processing of small numbers as compared to large ones; and in Exp. 2, with leftward shifts after large even numbers (6,8) and rightward shifts after large odd numbers (7,9). These results provide evidence of bidirectional links between number and space and extend them to the vertical dimension. Moreover, they document the influence of visuo-spatial attention on processing of numerical magnitude, numerical distance, and parity. Together, our findings are in line with grounded and embodied accounts of numerical cognition.
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Affiliation(s)
| | | | - Elvio Blini
- Department of General Psychology, University of Padua, Italy
| | - Matteo Lisi
- Department of Psychology, University of Essex, UK
| | - Marco Zorzi
- Department of General Psychology, University of Padua, Italy; IRCCS San Camillo Hospital, Venice-Lido, Italy.
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6
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Fattorini L, Rodio A, Pettorossi VE, Filippi GM. Is the Focal Muscle Vibration an Effective Motor Conditioning Intervention? A Systematic Review. J Funct Morphol Kinesiol 2021; 6:39. [PMID: 33924916 PMCID: PMC8167707 DOI: 10.3390/jfmk6020039] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 11/26/2022] Open
Abstract
Mechanical vibration, applied to single or few muscles, can be a selective stimulus for muscle spindles, able to modify neuromuscular management, inducing short and long-term effects, are now mainly employed in clinic studies. Several studies reported as treatments with focal vibratory (FVT) can influence neuromuscular parameters also in healthy people. However, the application modalities and the consequent effects are remarkably fragmented. This paper aims to review these studies and to characterize the FVT effectiveness on long-term conditional capacities in relation to FVT characteristics. A systematic search of studies published from 1985 to 2020 in English on healthcare databases was performed. Articles had to meet the following criteria: (1) treatment based on a locally applied vibration on muscle belly or tendon; (2) healthy adults involved; (3) outcomes time analysis enduring for more than 24 h. Twelve studies were found, all of them presented an excellent quality score of ≥75%. All selected papers reported positive changes, comparable with traditional long-lasting training effects. Muscle force and power were the most investigated parameters. The after-effects persisted for up to several months. Among the different FV administration modalities, the most effective seems to show a stimulus frequency of ≈100 Hz, repeated more times within three-five days on a voluntary contracted muscle.
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Affiliation(s)
- Luigi Fattorini
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Roma, Piazz.le A. Moro, 5, 00185 Roma, Italy
| | - Angelo Rodio
- Department of Human Sciences, Society and Health, University of Cassino e Lazio Meridionale Via S. Angelo—Località Folcara, 03043 Cassino, Italy;
| | - Vito E. Pettorossi
- Department of Medicine and Surgery, University of Perugia, Piazza dell’Università, 1, 06123 Perugia, Italy;
| | - Guido M. Filippi
- Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
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Ceyte H, Beis JM, Ceyte G, Caudron S. Perceptual post-effects of left neck muscle vibration with visuo-haptic feedback in healthy individuals: A potential approach for treating spatial neglect. Neurosci Lett 2020; 743:135557. [PMID: 33352280 DOI: 10.1016/j.neulet.2020.135557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/01/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
Among the techniques used to reduce spatial neglect's symptoms, left neck muscle vibration (NMV) is alluring because it does not require the patient's attentional co-operation. The aim of this study was to determine the type of NMV-associated feedback that induced the most intense and longest-lasting egocentric post-effects. Eighty-seven healthy individuals were randomly assigned to four intervention groups: "neck muscle vibration, blindfolded" (NMV), "neck muscle vibration with vision" (NMV + V), "neck muscle vibration and visual finger-pointing" (NMV + P), and "visual finger-pointing" (P). An eyes-closed finger-pointing subjective straight-ahead (SSA) test was carried out before the intervention, immediately afterwards, and 30 min afterwards. The results showed that only the NMV + P intervention induced a lasting leftward bias of SSA. In addition, the deviation reported in this intervention group differed significantly from those observed in the other interventions. The combination of visuo-haptic feedback and neck-somatosensory stimulation may enable a full, lasting intermodal recalibration, which could be potentiated by the attention level engaged during voluntary pointing. These outcomes highlighted that the NMV technique could easily integrate into routine occupational therapy sessions for treating various aspects of neglect disorders.
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Affiliation(s)
- Hadrien Ceyte
- Université de Lorraine, DevAH, F-54000, Nancy, France.
| | - Jean-Marie Beis
- Université de Lorraine, DevAH, F-54000, Nancy, France; Institut Régional de Médecine Physique et de Réadaptation de Nancy, Centre de Médecine Physique et de Réadaptation, F-54690, Lay-Saint-Christophe, France
| | | | - Sébastien Caudron
- Université de Lorraine, DevAH, F-54000, Nancy, France; Univ. Grenoble Alpes, CNRS, LPNC, 38000 Grenoble, France
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Regenhardt RW, Takase H, Lo EH, Lin DJ. Translating concepts of neural repair after stroke: Structural and functional targets for recovery. Restor Neurol Neurosci 2020; 38:67-92. [PMID: 31929129 PMCID: PMC7442117 DOI: 10.3233/rnn-190978] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Stroke is among the most common causes of adult disability worldwide, and its disease burden is shifting towards that of a long-term condition. Therefore, the development of approaches to enhance recovery and augment neural repair after stroke will be critical. Recovery after stroke involves complex interrelated systems of neural repair. There are changes in both structure (at the molecular, cellular, and tissue levels) and function (in terms of excitability, cortical maps, and networks) that occur spontaneously within the brain. Several approaches to augment neural repair through enhancing these changes are under study. These include identifying novel drug targets, implementing rehabilitation strategies, and developing new neurotechnologies. Each of these approaches has its own array of different proposed mechanisms. Current investigation has emphasized both cellular and circuit-based targets in both gray and white matter, including axon sprouting, dendritic branching, neurogenesis, axon preservation, remyelination, blood brain barrier integrity, blockade of extracellular inhibitory signals, alteration of excitability, and promotion of new brain cortical maps and networks. Herein, we review for clinicians recovery after stroke, basic elements of spontaneous neural repair, and ongoing work to augment neural repair. Future study requires alignment of basic, translational, and clinical research. The field continues to grow while becoming more clearly defined. As thrombolysis changed stroke care in the 1990 s and thrombectomy in the 2010 s, the augmentation of neural repair and recovery after stroke may revolutionize care for these patients in the coming decade.
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Affiliation(s)
- Robert W Regenhardt
- Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114
| | - Hajime Takase
- Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114
| | - Eng H Lo
- Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114
| | - David J Lin
- Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114
- Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114
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Effects of focal vibration on power and work in multiple wingate tests. Biol Sport 2019; 37:25-31. [PMID: 32205907 PMCID: PMC7075225 DOI: 10.5114/biolsport.2020.89938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/14/2019] [Accepted: 10/17/2019] [Indexed: 12/27/2022] Open
Abstract
The aim of the study was to assess the effects of a specific protocol, based on a focal muscle vibration, on mechanical parameters in an exercise composed of five repeated bouts of sprint interval tests (Wingate Anaerobic Tests, 10 seconds duration). Twenty-eight young male healthy subjects were randomized to two groups (VIB and CTRL). Peak power (PP), average peak between bouts (aP) and total exercise work (TW) were measured. In both groups, three different exercise sessions were carried out, interspersed by seven days: T0, T1 and T2. Between the baseline (T0) and T1, in the VIB group the intervention was administered on three successive days on quadriceps muscles, whereas a placebo administration was carried out in the CTRL group at the same time. At T1 (30 minutes after intervention) and T2 (7 days after) CTRL did not show any significant change, whereas VIB showed significant increases in PP (11.4%–9.3%), aP (6.6%–6.9%) and TW (5.7%–7.9%) with respect to T0. The results could be explained by an ameliorative agonist-antagonist balance, and this hypothesis is coherent with the literature. On the basis of the present findings, the investigated intervention might be usefully adopted to increase muscular power and endurance.
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10
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Lucente G, Valls-Sole J, Murillo N, Rothwell J, Coll J, Davalos A, Kumru H. Noninvasive Brain Stimulation and Noninvasive Peripheral Stimulation for Neglect Syndrome Following Acquired Brain Injury. Neuromodulation 2019; 23:312-323. [PMID: 31725939 DOI: 10.1111/ner.13062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/10/2019] [Accepted: 09/10/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Hemispatial neglect is a frequent condition usually following nondominant hemispheric brain injury. It strongly affects rehabilitation strategies and everyday life activities. It is associated with behavioral and cognitive disability with a strong impact on patient's life. METHODS We reviewed the published literature on the use of noninvasive brain stimulation, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), and of noninvasive peripheral muscle stimulation, as therapeutic strategies for rehabilitation of neglect after acquired brain injury, such as in stroke or in traumatic injuries. The studies were grouped as controlled or uncontrolled studies in each stimulation techniques. RESULTS Thirty-four studies were identified and 16 on rTMS, 10 on tDCS, and 8 on vibration. All studies were conducted in adult patients who suffered a stroke, except for one that was conducted in a patient suffering traumatic acquired brain injury and another that was conducted in a patient with brain tumor. In spite of significant variability in treatment protocols, patients' features and assessment of neglect, improvement was reported in almost all studies with no side-effects. CONCLUSIONS Noninvasive brain stimulation and neuromuscular vibration are promising therapeutic neuromodulatory approaches for neglect. Further randomized-controlled studies are needed to corroborate their effectiveness as separate and combined techniques.
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Affiliation(s)
- Giuseppe Lucente
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Spain.,Grup de Recerca en Malalties Neuromusculars i Neuropediatriques, Department of Neurosciences, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Josep Valls-Sole
- EMG Department, Hospital Clinic, Carrer de Villarroel, 170, 08036 Barcelona, Spain
| | - Narda Murillo
- Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain.,Fundación Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, 08916, Badalona, Spain
| | - John Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, University College London, London, UK
| | - Jaume Coll
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Spain.,Grup de Recerca en Malalties Neuromusculars i Neuropediatriques, Department of Neurosciences, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Antoni Davalos
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Spain.,Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Hatice Kumru
- Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundación Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, 08916, Badalona, Spain
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Aranda-Moreno C, Jáuregui-Renaud K, Reyes-Espinosa J, Andrade-Galicia A, Bastida-Segura AE, González Carrazco LG. Stimulation of the Semicircular Canals or the Utricles by Clinical Tests Can Modify the Intensity of Phantom Limb Pain. Front Neurol 2019; 10:117. [PMID: 30863355 PMCID: PMC6399116 DOI: 10.3389/fneur.2019.00117] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/29/2019] [Indexed: 11/13/2022] Open
Abstract
Background: After amputation, phantom limb pain may be produced by the multisensory processes underling the experience of an intact body. Clinical evidence has shown that cold caloric vestibular stimulation may modify the perception of phantom limb pain. However, it is yet unknown if this effect can be observed after the mild vestibular stimulation given by the clinical caloric test, or after utricle stimulation by centrifugation. Additionally, there are no studies on the association between the report of altered perceptions or experience of the self or the environment (depersonalization/derealization symptoms) and phantom limb pain. Objective: To assess the influence of unilateral stimulation of the horizontal semicircular canals by clinical caloric test, and the utricles by unilateral centrifugation on the intensity of phantom limb pain, and to explore the association between phantom limb pain and symptoms of depersonalization/ derealization. Methods: 34 patients (56 ±7 years old, 23 men) accepted to participate after 3 to 23 months of unilateral supracondylar amputation, secondary to type 2 diabetes mellitus. After assessment of vestibular function and symptoms of common mental disorders, using a cross-over design, in 2 separate sessions with 1 week in between, vestibular stimulation was delivered by right/left caloric test (30 or 44°C) or right/ left centrifugation (3.85 cm, 300°/s peak). Before and after each vestibular stimulus, the intensity of phantom limb pain and depersonalization/derealization symptoms were assessed, with a daily follow-up of pain intensity during 1 week. Results: Either caloric stimulation or unilateral centrifugation decreased phantom limb pain (p < 0.05), along with decrease of symptoms of depersonalization/derealization (p < 0.05). One third of the patients reporting pain decrease immediately after stimulation also reported no pain at least for 1 day. Limitations: No sham condition was included. Conclusions: Vestibular stimulation by the clinical caloric tests or by unilateral centrifugation may decrease the intensity of phantom limb pain, with decrease of perceptions of unreality. These effects might be related to an update of the immediate experience of the body, given by the sensory mismatch induced by asymmetrical vestibular stimulation.
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Affiliation(s)
- Catalina Aranda-Moreno
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Kathrine Jáuregui-Renaud
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Jaime Reyes-Espinosa
- Hospital General de Zona 1"A", Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Ana E Bastida-Segura
- Hospital General de Zona 47, Instituto Mexicano del Seguro Social, Mexico City, Mexico
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Ceyte H, Beis JM, Simon M, Rémy A, Anxionnat R, Paysant J, Caudron S. Lasting improvements in left spatial neglect following a protocol combining neck-muscle vibration and voluntary arm movements: a case-study. Disabil Rehabil 2018; 41:1475-1483. [DOI: 10.1080/09638288.2018.1430178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Hadrien Ceyte
- Development, Adaptation and Disability, EA 3450 DevAH, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Faculty of Sport Sciences, UFR-STAPS, Université de Lorraine, Villers-lès-Nancy, France
| | - Jean-Marie Beis
- Development, Adaptation and Disability, EA 3450 DevAH, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Faculty of Sport Sciences, UFR-STAPS, Université de Lorraine, Villers-lès-Nancy, France
- Centre de Médecine Physique et de Réadaptation, Institut Régional de Médecine Physique et de Réadaptation de Nancy, Lay-Saint-Christophe, France
| | - Mathilde Simon
- Development, Adaptation and Disability, EA 3450 DevAH, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Faculty of Sport Sciences, UFR-STAPS, Université de Lorraine, Villers-lès-Nancy, France
| | - Ariane Rémy
- Centre de Médecine Physique et de Réadaptation, Institut Régional de Médecine Physique et de Réadaptation de Nancy, Lay-Saint-Christophe, France
| | - René Anxionnat
- Centre Hospitalier Universitaire, Service de Neuroradiologie Diagnostique et Thérapeutique, Nancy, France
| | - Jean Paysant
- Development, Adaptation and Disability, EA 3450 DevAH, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Faculty of Sport Sciences, UFR-STAPS, Université de Lorraine, Villers-lès-Nancy, France
- Centre de Médecine Physique et de Réadaptation, Institut Régional de Médecine Physique et de Réadaptation de Nancy, Lay-Saint-Christophe, France
| | - Sébastien Caudron
- Development, Adaptation and Disability, EA 3450 DevAH, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Faculty of Sport Sciences, UFR-STAPS, Université de Lorraine, Villers-lès-Nancy, France
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13
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Abstract
Unilateral spatial neglect is a disabling neurologic deficit, most frequent and severe after right-hemispheric lesions. In most patients neglect involves the left side of space, contralateral to a right-hemispheric lesion. About 50% of stroke patients exhibit neglect in the acute phase. Patients fail to orient, respond to, and report sensory events occurring in the contralateral sides of space and of the body, to explore these portions of space through movements by action effectors (eye, limbs), and to move the contralateral limbs. Neglect is a multicomponent higher-level disorder of spatial awareness, cognition, and attention. Spatial neglect may occur independently of elementary sensory and motor neurologic deficits, but it can mimic and make them more severe. Diagnostic tests include: motor exploratory target cancellation; setting the midpoint of a horizontal line (bisection), that requires the estimation of lateral extent; drawing by copy and from memory; reading, assessing neglect dyslexia; and exploring the side of the body contralateral to the lesion. Activities of daily living scales are also used. Patients are typically not aware of neglect, although they may exhibit varying degrees of awareness toward different components of the deficit. The neural correlates include lesions to the inferior parietal lobule of the posterior parietal cortex, which was long considered the unique neuropathologic correlate of neglect, to the premotor and to the dorsolateral prefrontal cortices, to the posterior superior temporal gyrus, at the temporoparietal junction, to subcortical gray nuclei (thalamus, basal ganglia), and to parietofrontal white-matter fiber tracts, such as the superior longitudinal fascicle. Damage to the inferior parietal lobule of the posterior parietal cortex is specifically associated with the mainly egocentric, perceptual, and exploratory extrapersonal, and with the personal, bodily components of neglect. Productive manifestations, such as perseveration, are not a correlate of posterior parietal cortex damage.
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Kammermeier S, Dietrich L, Maierbeck K, Plate A, Lorenzl S, Singh A, Bötzel K. Neck Vibration Proprioceptive Postural Response Intact in Progressive Supranuclear Palsy unlike Idiopathic Parkinson's Disease. Front Neurol 2017; 8:689. [PMID: 29326649 PMCID: PMC5742483 DOI: 10.3389/fneur.2017.00689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 12/01/2017] [Indexed: 12/03/2022] Open
Abstract
Progressive supranuclear palsy (PSP) and late-stage idiopathic Parkinson’s disease (IPD) are neurodegenerative movement disorders resulting in different postural instability and falling symptoms. IPD falls occur usually forward in late stage, whereas PSP falls happen in early stages, mostly backward, unprovoked, and with high morbidity. Postural responses to sensory anteroposterior tilt illusion by bilateral dorsal neck vibration were probed in both groups versus healthy controls on a static recording posture platform. Three distinct anteroposterior body mass excursion peaks (P1–P3) were observed. 18 IPD subjects exhibited well-known excessive response amplitudes, whereas 21 PSP subjects’ responses remained unaltered to 22 control subjects. Neither IPD nor PSP showed response latency deficits, despite brainstem degeneration especially in PSP. The observed response patterns suggest that PSP brainstem pathology might spare the involved proprioceptive pathways and implies viability of neck vibration for possible biofeedback and augmentation therapy in PSP postural instability.
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Affiliation(s)
- Stefan Kammermeier
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany
| | - Lucia Dietrich
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany.,Abteilung für Allgemeinchirurgie, Kliniken Ostallgäu-Kaufbeuren, Kaufbeuren, Germany
| | - Kathrin Maierbeck
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany.,Klinikum der Universität München, Klinik für Anästhesiologie, München, Germany
| | - Annika Plate
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany
| | - Stefan Lorenzl
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany.,Abteilung für Neurologie, Krankenhaus Agatharied, Hausham, Germany
| | - Arun Singh
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany.,Department of Neurology, University of Iowa, Iowa, IA, United States
| | - Kai Bötzel
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany
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De Luca R, Lo Buono V, Leo A, Russo M, Aragona B, Leonardi S, Buda A, Naro A, Calabrò RS. Use of virtual reality in improving poststroke neglect: Promising neuropsychological and neurophysiological findings from a case study. APPLIED NEUROPSYCHOLOGY-ADULT 2017; 26:96-100. [PMID: 28937807 DOI: 10.1080/23279095.2017.1363040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
After experiencing a stroke in the right hemisphere, almost 50% of patients show unilateral spatial neglect (USN). Virtual Reality technologies offer impressive opportunities for both the rehabilitation and assessment of different cognitive deficits, including USN. A 57-year-old woman, affected by subarachnoid hemorrhage presented a severe left hemiparesis with severe cognitive and behavioral alterations, including temporal and spatial disorientation, reduction of attention and memory process, slowing ideation, USN, and depression of mood. She underwent two different rehabilitation trainings, including standard cognitive training (SCT) in addition to semi-immersive virtual training with her shadow (S-IVT_s) and SCT in addition to a Semi- immersive virtual training, without her shadow (S-IVT). The patient was assessed before and after each of the two different trainings, by using a specific psychometric battery and the event related potential, P300. Only at the end of the use of the S-IVT, we observed a significant improvement in the motor and cognitive function, with regard to USN. SCT in addition to S-IVT with Bts-Nirvana System may be a promising approach in improving attention process, spatial cognition, and mood in patients with post stroke USN, as also demonstrated by the electrophysiological parameters.
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Affiliation(s)
- Rosaria De Luca
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Viviana Lo Buono
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Antonino Leo
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Margherita Russo
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Bianca Aragona
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Simona Leonardi
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Antonio Buda
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Antonino Naro
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
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16
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Tobler-Ammann BC, Surer E, de Bruin ED, Rabuffetti M, Borghese NA, Mainetti R, Pirovano M, Wittwer L, Knols RH. Exergames Encouraging Exploration of Hemineglected Space in Stroke Patients With Visuospatial Neglect: A Feasibility Study. JMIR Serious Games 2017; 5:e17. [PMID: 28842388 PMCID: PMC5591404 DOI: 10.2196/games.7923] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/13/2017] [Accepted: 07/31/2017] [Indexed: 01/08/2023] Open
Abstract
Background Use of exergames can complement conventional therapy and increase the amount and intensity of visuospatial neglect (VSN) training. A series of 9 exergames—games based on therapeutic principles—aimed at improving exploration of the neglected space for patients with VSN symptoms poststroke was developed and tested for its feasibility. Objectives The goal was to determine the feasibility of the exergames with minimal supervision in terms of (1) implementation of the intervention, including adherence, attrition and safety, and (2) limited efficacy testing, aiming to document possible effects on VSN symptoms in a case series of patients early poststroke. Methods A total of 7 patients attended the 3-week exergames training program on a daily basis. Adherence of the patients was documented in a training diary. For attrition, the number of participants lost during the intervention was registered. Any adverse events related to the exergames intervention were noted to document safety. Changes in cognitive and spatial exploration skills were measured with the Zürich Maxi Mental Status Inventory and the Neglect Test. Additionally, we developed an Eye Tracker Neglect Test (ETNT) using an infrared camera to detect and measure neglect symptoms pre- and postintervention. Results The median was 14 out of 15 (93%) attended sessions, indicating that the adherence to the exergames training sessions was high. There were no adverse events and no drop-outs during the exergame intervention. The individual cognitive and spatial exploration skills slightly improved postintervention (P=.06 to P=.98) and continued improving at follow-up (P=.04 to P=.92) in 5 out of 7 (71%) patients. Calibration of the ETNT was rather error prone. The ETNT showed a trend for a slight median group improvement from 15 to 16 total located targets (+6%). Conclusions The high adherence rate and absence of adverse events showed that these exergames were feasible and safe for the participants. The results of the amount of exergames use is promising for future applications and warrants further investigations—for example, in the home setting of patients to augment training frequency and intensity. The preliminary results indicate the potential of these exergames to cause improvements in cognitive and spatial exploration skills over the course of training for stroke patients with VSN symptoms. Thus, these exergames are proposed as a motivating training tool to complement usual care. The ETNT showed to be a promising assessment for quantifying spatial exploration skills. However, further adaptations are needed, especially regarding calibration issues, before its use can be justified in a larger study sample.
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Affiliation(s)
- Bernadette C Tobler-Ammann
- Physiotherapy and Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland.,Care and Public Health Research Institute (CAPHRI], Maastricht University, Maastricht, Netherlands
| | - Elif Surer
- Graduate School of Informatics, Department of Modeling and Simulation, Middle East Technical University, Ankara, Turkey.,Applied Intelligent Systems Laboratory, Department of Computer Science, Università degli Studi di Milano, Milan, Italy
| | - Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich, Zurich, Switzerland
| | - Marco Rabuffetti
- Polo Tecnologico, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - N Alberto Borghese
- Applied Intelligent Systems Laboratory, Department of Computer Science, Università degli Studi di Milano, Milan, Italy
| | - Renato Mainetti
- Applied Intelligent Systems Laboratory, Department of Computer Science, Università degli Studi di Milano, Milan, Italy
| | - Michele Pirovano
- Applied Intelligent Systems Laboratory, Department of Computer Science, Università degli Studi di Milano, Milan, Italy
| | - Lia Wittwer
- Parkinson Center, Epileptology, Neurorehabilitation, Clinic Bethesda, Tschugg, Switzerland
| | - Ruud H Knols
- Physiotherapy and Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland
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17
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Ronchi R, Algeri L, Chiapella L, Gallucci M, Spada MS, Vallar G. Left neglect dyslexia: Perseveration and reading error types. Neuropsychologia 2016; 89:453-464. [DOI: 10.1016/j.neuropsychologia.2016.07.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 04/15/2016] [Accepted: 07/19/2016] [Indexed: 11/28/2022]
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18
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Turgut N, Miranda M, Kastrup A, Eling P, Hildebrandt H. tDCS combined with optokinetic drift reduces egocentric neglect in severely impaired post-acute patients. Neuropsychol Rehabil 2016; 28:515-526. [DOI: 10.1080/09602011.2016.1202120] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Nergiz Turgut
- Early Neurological Rehabilitation Unit, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, Carl von Ossietzky Universität, Oldenburg, Germany
| | - Marcela Miranda
- Early Neurological Rehabilitation Unit, Evangelisches Krankenhaus, Oldenburg, Germany
| | - Andreas Kastrup
- Early Neurological Rehabilitation Unit, Klinikum Bremen-Ost, Bremen, Germany
| | - Paul Eling
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Helmut Hildebrandt
- Early Neurological Rehabilitation Unit, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, Carl von Ossietzky Universität, Oldenburg, Germany
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19
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Masson N, Pesenti M, Dormal V. Impact of optokinetic stimulation on mental arithmetic. PSYCHOLOGICAL RESEARCH 2016; 81:840-849. [DOI: 10.1007/s00426-016-0784-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 06/19/2016] [Indexed: 11/29/2022]
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20
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Gallasch E, Christova M, Kunz A, Rafolt D, Golaszewski S. Modulation of sensorimotor cortex by repetitive peripheral magnetic stimulation. Front Hum Neurosci 2015; 9:407. [PMID: 26236220 PMCID: PMC4500907 DOI: 10.3389/fnhum.2015.00407] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 07/01/2015] [Indexed: 11/13/2022] Open
Abstract
This study examines with transcranial magnetic stimulation (TMS) and with functional magnetic resonance imaging (fMRI) whether 20 min of repetitive peripheral magnetic stimulation (rPMS) has a facilitating effect on associated motor controlling regions. Trains of rPMS with a stimulus intensity of 150% of the motor threshold (MT) were applied over right hand flexor muscles of healthy volunteers. First, with TMS, 10 vs. 25 Hz rPMS was examined and compared to a control group. Single and paired pulse motor evoked potentials (MEPs) from flexor carpi radialis (FCR) and extensor carpi radialis (ECR) muscles were recorded at baseline (T0), post rPMS (T1), 30 min post (T2), 1 h post (T3) and 2 h post rPMS (T4). Then, with fMRI, 25 Hz rPMS was compared to sham stimulation by utilizing a finger tapping activation paradigm. Changes in bloodoxygen level dependent (BOLD) contrast were examined at baseline (PRE), post rPMS (POST1) and 1 h post rPMS (POST2). With TMS facilitation was observed in the target muscle (FCR) following 25 Hz rPMS: MEP recruitment curves (RCs) were increased at T1, T2 and T3, and intracortical facilitation (ICF) was increased at T1 and T2. No effects were observed following 10 Hz rPMS. With fMRI the BOLD contrast at the left sensorimotor area was increased at POST1. Compared to inductions protocols based on transcutaneous electrical stimulation and mechanical stimulation, the rPMS induced effects appeared shorter lasting.
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Affiliation(s)
- Eugen Gallasch
- Department of Physiology, Medical University of Graz Graz, Austria
| | - Monica Christova
- Department of Physiology, Medical University of Graz Graz, Austria ; Institute of Physiotherapy, University of Applied Sciences FH-Joanneum Graz, Austria
| | - Alexander Kunz
- Department of Neurology, Paracelsus Medical University of Salzburg Salzburg, Austria
| | - Dietmar Rafolt
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna Vienna, Austria
| | - Stefan Golaszewski
- Department of Neurology, Paracelsus Medical University of Salzburg Salzburg, Austria
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21
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Pitteri M, Kerkhoff G, Keller I, Meneghello F, Priftis K. Extra-powerful on the visuo-perceptual space, but variable on the number space: Different effects of optokinetic stimulation in neglect patients. J Neuropsychol 2014; 9:299-318. [PMID: 25145402 DOI: 10.1111/jnp.12051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 07/10/2014] [Indexed: 11/26/2022]
Abstract
We studied the effects of optokinetic stimulation (OKS; leftward, rightward, control) on the visuo-perceptual and number space, in the same sample, during line bisection and mental number interval bisection tasks. To this end, we tested six patients with right-hemisphere damage and neglect, six patients with right-hemisphere damage but without neglect, and six neurologically healthy participants. In patients with neglect, we found a strong effect of leftward OKS on line bisection, but not on mental number interval bisection. We suggest that OKS influences the number space only under specific conditions.
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Affiliation(s)
- Marco Pitteri
- Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy
| | - Georg Kerkhoff
- Clinical Neuropsychology Unit and Outpatient Service, Saarland University, Saarbrücken, Germany.,International Research Training Group 1457 "Adaptive Minds", Saarbrücken, Germany
| | - Ingo Keller
- Clinical Neuropsychology Unit, Schön Clinic Bad Aibling, Germany
| | | | - Konstantinos Priftis
- Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy.,Department of General Psychology, University of Padova, Italy
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22
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Ranzini M, Lisi M, Blini E, Pitteri M, Treccani B, Priftis K, Zorzi M. Larger, smaller, odd or even? Task-specific effects of optokinetic stimulation on the mental number space. JOURNAL OF COGNITIVE PSYCHOLOGY 2014. [DOI: 10.1080/20445911.2014.941847] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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Pitzalis S, Spinelli D, Vallar G, Di Russo F. Transcutaneous electrical nerve stimulation effects on neglect: a visual-evoked potential study. Front Hum Neurosci 2013; 7:111. [PMID: 23966919 PMCID: PMC3746501 DOI: 10.3389/fnhum.2013.00111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 08/05/2013] [Indexed: 12/03/2022] Open
Abstract
We studied the effects of transcutaneous electrical nerve stimulation (TENS) in six right-brain-damaged patients with left unilateral spatial neglect (USN), using both standard clinical tests (reading, line, and letter cancelation, and line bisection), and electrophysiological measures (steady-state visual-evoked potentials, SSVEP). TENS was applied on left neck muscles for 15′, and measures were recorded before, immediately after, and 60′ after stimulation. Behavioral results showed that the stimulation temporarily improved the deficit in all patients. In cancelation tasks, omissions and performance asymmetries between the two hand-sides were reduced, as well as the rightward deviation in line bisection. Before TENS, SSVEP average latency to stimuli displayed in the left visual half-field [LVF (160 ms)] was remarkably longer than to stimuli shown in the right visual half-field [RVF (120 ms)]. Immediately after TENS, latency to LVF stimuli was 130 ms; 1 h after stimulation the effect of TENS faded, with latency returning to baseline. TENS similarly affected also the latency SSVEP of 12 healthy participants, and their line bisection performance, with effects smaller in size. The present study, first, replicates evidence concerning the positive behavioral effects of TENS on the manifestations of left USN in right-brain-damaged patients; second, it shows putatively related electrophysiological effects on the SSVEP latency. These behavioral and novel electrophysiological results are discussed in terms of specific directional effects of left somatosensory stimulation on egocentric coordinates, which in USN patients are displaced toward the side of the cerebral lesion. Showing that visual-evoked potentials latency is modulated by proprioceptive stimulation, we provide electrophysiological evidence to the effect that TENS may improve some manifestations of USN, with implications for its rehabilitation.
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Affiliation(s)
- Sabrina Pitzalis
- Department of Human Movement, Social and Health Sciences, University of Rome , Foro Italico , Italy ; Neuropsychology Unit, IRCCS Santa Lucia Foundation , Rome , Italy
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24
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Schmidt L, Utz KS, Depper L, Adams M, Schaadt AK, Reinhart S, Kerkhoff G. Now You Feel both: Galvanic Vestibular Stimulation Induces Lasting Improvements in the Rehabilitation of Chronic Tactile Extinction. Front Hum Neurosci 2013; 7:90. [PMID: 23519604 PMCID: PMC3602932 DOI: 10.3389/fnhum.2013.00090] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 03/03/2013] [Indexed: 11/16/2022] Open
Abstract
Tactile extinction is frequent, debilitating, and often persistent after brain damage. Currently, there is no treatment available for this disorder. In two previous case studies we showed an influence of galvanic vestibular stimulation (GVS) on tactile extinction. Here, we evaluated in further patients the immediate and lasting effects of GVS on tactile extinction. GVS is known to induce polarity-specific changes in cerebral excitability in the vestibular cortices and adjacent cortical areas. Tactile extinction was examined with the Quality Extinction Test (QET) where subjects have to discriminate six different tactile fabrics in bilateral, double simultaneous stimulations on their dorsum of hands with identical or different tactile fabrics. Twelve patients with stable left-sided tactile extinction after unilateral right-hemisphere lesions were divided into two groups. The GVS group (N = 6) performed the QET under six different experimental conditions (two Baselines, Sham-GVS, left-cathodal/right-anodal GVS, right-cathodal/left-anodal GVS, and a Follow-up test). The second group of patients with left-sided extinction (N = 6) performed the QET six times repetitively, but without receiving GVS (control group). Both right-cathodal/left-anodal as well as left-cathodal/right-anodal GVS (mean: 0.7 mA) improved tactile identification of identical and different stimuli in the experimental group. These results show a generic effect of GVS on tactile extinction, but not in a polarity-specific way. These observed effects persisted at follow-up. Sham-GVS had no significant effect on extinction. In the control group, no significant improvements were seen in the QET after the six measurements of the QET, thus ruling out test repetition effects. In conclusion, GVS improved bodily awareness permanently for the contralesional body side in patients with tactile extinction and thus offers a novel treatment option for these patients.
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Affiliation(s)
- Lena Schmidt
- Clinical Neuropsychology Unit and Outpatient Service, Saarland University Saarbruecken, Germany ; International Research Training Group 1457 "Adaptive Minds," Saarbruecken, Germany
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Zubko O, Wilkinson D, Langston D, Sakel M. The effect of repeated sessions of galvanic vestibular stimulation on target cancellation in visuo-spatial neglect: preliminary evidence from two cases. Brain Inj 2013; 27:613-9. [PMID: 23473288 DOI: 10.3109/02699052.2013.767938] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In recent years it has emerged that the attentional disorder of visuo-spatial neglect can be overcome via artificial stimulation of the balance system. One means of achieving this is via galvanic vestibular stimulation (GVS), a simple procedure in which tiny, electrical currents are discharged to the part of the scalp overlying the vestibular nerves. Attempts to remediate neglect with GVS have utilized only a single session of stimulation and, although this can induce spontaneous recovery, symptoms resurface soon after stimulation. This study assessed whether repeated sessions induce longer carry-over. METHODS Two individuals diagnosed with neglect post-stroke received 5 days of sub-sensory, left anodal GVS. Performance was assessed via the letter and star cancellation tasks of the Behavioural Inattention Test on four occasions; 3 days before the start of stimulation, on the first and last day of stimulation and 3-days after stimulation. RESULTS Analyses of variance indicated that both participants missed significantly fewer targets in both tasks on the fifth day of stimulation compared to baseline. More so, this improvement was still evident at follow-up 3 days later. CONCLUSION The results strengthen the need for a larger, sham-controlled trial to establish whether repeated GVS provides lasting relief from neglect.
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Affiliation(s)
- Olga Zubko
- School of Psychology, University of Kent, UK
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26
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Bolognini N, Convento S, Rossetti A, Merabet LB. Multisensory processing after a brain damage: Clues on post-injury crossmodal plasticity from neuropsychology. Neurosci Biobehav Rev 2013; 37:269-78. [DOI: 10.1016/j.neubiorev.2012.12.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 10/03/2012] [Accepted: 12/09/2012] [Indexed: 11/28/2022]
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Schmidt L, Keller I, Utz KS, Artinger F, Stumpf O, Kerkhoff G. Galvanic Vestibular Stimulation Improves Arm Position Sense in Spatial Neglect. Neurorehabil Neural Repair 2013; 27:497-506. [DOI: 10.1177/1545968312474117] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Disturbed arm position sense (APS) is a frequent and debilitating condition in patients with hemiparesis after stroke. Patients with neglect, in particular, show a significantly impaired contralesional APS. Currently, there is no treatment available for this disorder. Galvanic vestibular stimulation (GVS) may ameliorate neglect and extinction by activating the thalamocortical network. Objective. The present study aimed to investigate the immediate effects and aftereffects (AEs; 20 minutes) of subsensory, bipolar GVS ( M = 0.6 mA current intensity) on APS in stroke patients with versus without spatial neglect and matched healthy controls. Methods. A novel optoelectronic arm position device was developed, enabling the precise measurement of the horizontal APS of both arms. In all, 10 healthy controls, 7 patients with left-sided hemiparesis and left-spatial neglect, and 15 patients with left hemiparesis but without neglect were tested. Horizontal APS was measured separately for both forearms under 4 experimental conditions (baseline without GVS, left-cathodal/right-anodal GVS, right-cathodal/left-anodal GVS, sham GVS). The immediate effects during GVS and the AEs 20 minutes after termination of GVS were examined. Results. Patients with neglect showed an impaired contralateral APS in contrast to patients without neglect and healthy controls. Left-cathodal/right-anodal GVS improved left APS significantly, which further improved into the normal range 20 minutes poststimulation. GVS had no effect in patients without neglect but right-cathodal/left-anodal GVS worsened left APS in healthy participants significantly. Conclusions. GVS can significantly improve the impaired APS in neglect. Multisession GVS can be tested to induce enduring therapeutic effects.
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Affiliation(s)
- Lena Schmidt
- Saarland University, Saarbruecken, Germany
- International Research Training Group 1457 “Adaptive Minds,” Saarbruecken, Germany
| | | | - Kathrin S. Utz
- Saarland University, Saarbruecken, Germany
- University of Erlangen-Nuremberg, Erlangen, Germany
| | | | | | - Georg Kerkhoff
- Saarland University, Saarbruecken, Germany
- International Research Training Group 1457 “Adaptive Minds,” Saarbruecken, Germany
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Machner B, Dorr M, Sprenger A, von der Gablentz J, Heide W, Barth E, Helmchen C. Impact of dynamic bottom-up features and top-down control on the visual exploration of moving real-world scenes in hemispatial neglect. Neuropsychologia 2012; 50:2415-25. [PMID: 22750122 DOI: 10.1016/j.neuropsychologia.2012.06.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 05/29/2012] [Accepted: 06/18/2012] [Indexed: 10/28/2022]
Abstract
Patients with hemispatial neglect are severely impaired in orienting their attention to contralesional hemispace. Although motion is one of the strongest attentional cues in humans, it is still unknown how neglect patients visually explore their moving real-world environment. We therefore recorded eye movements at bedside in 19 patients with hemispatial neglect following acute right hemisphere stroke, 14 right-brain damaged patients without neglect and 21 healthy control subjects. Videos of naturalistic real-world scenes were presented first in a free viewing condition together with static images, and subsequently in a visual search condition. We analyzed number and amplitude of saccades, fixation durations and horizontal fixation distributions. Novel computational tools allowed us to assess the impact of different scene features (static and dynamic contrast, colour, brightness) on patients' gaze. Independent of the different stimulus conditions, neglect patients showed decreased numbers of fixations in contralesional hemispace (ipsilesional fixation bias) and increased fixation durations in ipsilesional hemispace (disengagement deficit). However, in videos left-hemifield fixations of neglect patients landed on regions with particularly high dynamic contrast. Furthermore, dynamic scenes with few salient objects led to a significant reduction of the pathological ipsilesional fixation bias. In visual search, moving targets in the neglected hemifield were more frequently detected than stationary ones. The top-down influence (search instruction) could neither reduce the ipsilesional fixation bias nor the impact of bottom-up features. Our results provide evidence for a strong impact of dynamic bottom-up features on neglect patients' scanning behaviour. They support the neglect model of an attentional priority map in the brain being imbalanced towards ipsilesional hemispace, which can be counterbalanced by strong contralateral motion cues. Taking into account the lack of top-down control in neglect patients, bottom-up stimulation with moving real-world stimuli may be a promising candidate for future neglect rehabilitation schemes.
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Affiliation(s)
- Björn Machner
- Department of Neurology, University of Lübeck, Lübeck, Germany.
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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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30
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Kerkhoff G, Keller I, Artinger F, Hildebrandt H, Marquardt C, Reinhart S, Ziegler W. Recovery from auditory and visual neglect after optokinetic stimulation with pursuit eye movements – Transient modulation and enduring treatment effects. Neuropsychologia 2012; 50:1164-77. [DOI: 10.1016/j.neuropsychologia.2011.09.032] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Revised: 09/14/2011] [Accepted: 09/15/2011] [Indexed: 10/17/2022]
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31
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Mancini F, Bricolo E, Mattioli FC, Vallar G. Visuo-haptic interactions in unilateral spatial neglect: the cross modal judd illusion. Front Psychol 2011; 2:341. [PMID: 22164149 PMCID: PMC3222222 DOI: 10.3389/fpsyg.2011.00341] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 11/01/2011] [Indexed: 11/13/2022] Open
Abstract
Unilateral spatial neglect (USN) has been mainly investigated in the visual modality; only few studies compared spatial neglect across different sensory modalities, and explored their multisensory interactions, with controversial results. We investigated the integration between vision and haptics, through a bisection task of a cross modal illusion, the Judd variant of the Müller-Lyer illusion. We examined right-brain-damaged patients with (n = 7) and without (n = 7) left USN, and neurologically unimpaired participants (n = 14) in the bisection of Judd stimuli under visual, haptic, and visuo-haptic presentation. Neglect patients showed the characteristic rightward bias in the bisection of the baseline stimuli in the visual modality, but not in the haptic and visuo-haptic conditions. The illusory effects were preserved in each group and in each modality, indicating that the processing of the cross modal illusion is independent of the presence of deficits of spatial attention and representation. Spatial neglect can be modality-specific, but visual and tactile sensory inputs are properly integrated.
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Affiliation(s)
- Flavia Mancini
- Department of Psychology, University of Milano-BicoccaMilano, Italy
- Neuropsychological Laboratory, IRCCS Italian Auxological InstituteMilano, Italy
| | - Emanuela Bricolo
- Department of Psychology, University of Milano-BicoccaMilano, Italy
| | | | - Giuseppe Vallar
- Department of Psychology, University of Milano-BicoccaMilano, Italy
- Neuropsychological Laboratory, IRCCS Italian Auxological InstituteMilano, Italy
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32
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Hesse MD, Sparing R, Fink GR. Ameliorating spatial neglect with non-invasive brain stimulation: From pathophysiological concepts to novel treatment strategies. Neuropsychol Rehabil 2011; 21:676-702. [DOI: 10.1080/09602011.2011.573931] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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33
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Utz KS, Korluss K, Schmidt L, Rosenthal A, Oppenländer K, Keller I, Kerkhoff G. Minor adverse effects of galvanic vestibular stimulation in persons with stroke and healthy individuals. Brain Inj 2011; 25:1058-69. [DOI: 10.3109/02699052.2011.607789] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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34
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Reinhart S, Schindler I, Kerkhoff G. Optokinetic stimulation affects word omissions but not stimulus-centered reading errors in paragraph reading in neglect dyslexia. Neuropsychologia 2011; 49:2728-35. [DOI: 10.1016/j.neuropsychologia.2011.05.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 03/29/2011] [Accepted: 05/26/2011] [Indexed: 11/15/2022]
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Saevarsson S, Halsband U, Kristjansson A. Designing rehabilitation programs for neglect: could 2 be more than 1+1? APPLIED NEUROPSYCHOLOGY 2011; 18:95-106. [PMID: 21660761 PMCID: PMC4544767 DOI: 10.1080/09084282.2010.547774] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Unilateral neglect is a multimodal neuropsychological disorder that has puzzled scientists for a long time. Many interventions have been developed, but only a handful has proven to be effective. This review examines whether applying different therapeutic techniques in combination will increase therapeutic benefits. Studies were reviewed where therapies are applied sequentially or in combination with other techniques. The results indicate that combining different interventions leads to increased general improvement compared with other noncombined designs, even when the number of treatment sessions is not constant. Practical and theoretical aspects of different treatments are discussed. The combined approach to treatment may have direct relevance to disorders other than neglect. This report introduces a new classification scheme for different interventions with the aim of facilitating more focused therapy. Finally, suggestions are made as to what the focus of future studies of neglect therapy should be and how therapeutic benefits might be maximized.
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Affiliation(s)
- Styrmir Saevarsson
- Department of Psychology, Neuropsychology, University of Freiburg, Germany.
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36
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Utz KS, Keller I, Kardinal M, Kerkhoff G. Galvanic vestibular stimulation reduces the pathological rightward line bisection error in neglect-a sham stimulation-controlled study. Neuropsychologia 2011; 49:1219-1225. [PMID: 21371483 DOI: 10.1016/j.neuropsychologia.2011.02.046] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 11/24/2010] [Accepted: 02/22/2011] [Indexed: 11/30/2022]
Abstract
Patients with right hemisphere lesions often show left spatial neglect and the typical rightward deviation in horizontal line bisection. Previous studies have shown that sensory stimulation modulates line bisection. A less well-known but promising sensory stimulation method is galvanic vestibular stimulation (GVS). This non-invasive technique leads to activation of the vestibular cortices and adjacent cortical areas in the temporo-parietal cortex via polarization effects of the vestibular nerves. This is accomplished by application of weak direct currents, delivered by two electrodes attached to the mastoids. Despite the relative benefits of GVS its effects on line bisection have not yet been studied in neglect patients. Thus, the present study investigated the impact of GVS on performance in a modified line bisection task in right-brain damaged patients with versus without leftsided visual neglect. In neglect patients, but not in control patients, left-cathodal and right-cathodal GVS significantly reduced the rightward line bisection error as compared to Baseline (without GVS) and sham stimulation. A larger decrease of the rightward line bisection error was observed during right-cathodal GVS. Sham stimulation showed no specific effects on line bisection. The beneficial effects of GVS might be due to activation of preserved structures of the lesioned right posterior parietal cortex which is known to be involved in line bisection.
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Affiliation(s)
- Kathrin S Utz
- Saarland University, Clinical Neuropsychology Unit, Saarbruecken, Germany; International Research Training Group 1457 "Adaptive Minds", Saarbruecken, Germany.
| | - Ingo Keller
- Schoen Clinic Bad Aibling, Department of Neuropsychology, Germany
| | - Mareike Kardinal
- Saarland University, Clinical Neuropsychology Unit, Saarbruecken, Germany; International Research Training Group 1457 "Adaptive Minds", Saarbruecken, Germany
| | - Georg Kerkhoff
- Saarland University, Clinical Neuropsychology Unit, Saarbruecken, Germany; International Research Training Group 1457 "Adaptive Minds", Saarbruecken, Germany.
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37
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Kerkhoff G, Hildebrandt H, Reinhart S, Kardinal M, Dimova V, Utz KS. A long-lasting improvement of tactile extinction after galvanic vestibular stimulation: Two Sham-stimulation controlled case studies. Neuropsychologia 2011; 49:186-95. [DOI: 10.1016/j.neuropsychologia.2010.11.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 10/15/2010] [Accepted: 11/12/2010] [Indexed: 10/18/2022]
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38
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Reinhart S, Keller I, Kerkhoff G. Effects of head rotation on space- and word-based reading errors in spatial neglect. Neuropsychologia 2010; 48:3706-14. [DOI: 10.1016/j.neuropsychologia.2010.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Revised: 08/13/2010] [Accepted: 09/03/2010] [Indexed: 10/19/2022]
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39
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Vallar G, Burani C, Arduino LS. Neglect dyslexia: a review of the neuropsychological literature. Exp Brain Res 2010; 206:219-35. [DOI: 10.1007/s00221-010-2386-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 07/29/2010] [Indexed: 10/19/2022]
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40
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Utz KS, Dimova V, Oppenländer K, Kerkhoff G. Electrified minds: Transcranial direct current stimulation (tDCS) and Galvanic Vestibular Stimulation (GVS) as methods of non-invasive brain stimulation in neuropsychology—A review of current data and future implications. Neuropsychologia 2010; 48:2789-810. [DOI: 10.1016/j.neuropsychologia.2010.06.002] [Citation(s) in RCA: 284] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Revised: 04/15/2010] [Accepted: 06/03/2010] [Indexed: 10/19/2022]
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41
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Figliozzi F, Silvetti M, Rubichi S, Doricchi F. Determining priority between attentional and referential-coding sources of the Simon effect through optokinetic stimulation. Neuropsychologia 2010; 48:1011-5. [PMID: 19961865 DOI: 10.1016/j.neuropsychologia.2009.11.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 11/23/2009] [Accepted: 11/26/2009] [Indexed: 11/26/2022]
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42
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Wilkinson D, Zubko O, Degutis J, Milberg W, Potter J. Improvement of a figure copying deficit during subsensory galvanic vestibular stimulation. J Neuropsychol 2009; 4:107-18. [PMID: 19706224 DOI: 10.1348/174866409x468205] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We describe the effects of galvanic vestibular stimulation (GVS) on an individual who, following right hemisphere stroke, is unable to copy figures accurately. His copies contain most of the constituent elements, but are poorly integrated and drawn in a seemingly haphazard manner. To test whether GVS could help overcome these difficulties, we administered the Rey-Osterrieth complex figure copy task while manipulating both the presence and laterality of the galvanic signal. The signal was applied at a level that was too low to elicit sensation which ensured that the individual was unaware of either when or on what side he was being stimulated. Relative to a sham condition, two consecutive blocks of GVS increased both the accuracy with which the main configural elements of the figure were reconstructed, and there was some, albeit less consistent evidence, that these were drawn in a more wholistic as opposed to piecemeal manner. Improvement was not reliant on the polarity of the stimulating electrodes. These results suggest that GVS can help overcome difficulties in the perception and/or reconstruction of hierarchical visual form, and thereby uncover a new link between vestibular information processing and visual task performance.
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Affiliation(s)
- David Wilkinson
- Department of Psychology, University of Kent, Canterbury, Kent, UK.
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43
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Thimm M, Fink GR, Küst J, Karbe H, Willmes K, Sturm W. Recovery from hemineglect: Differential neurobiological effects of optokinetic stimulation and alertness training. Cortex 2009; 45:850-62. [DOI: 10.1016/j.cortex.2008.10.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Revised: 05/08/2008] [Accepted: 10/10/2008] [Indexed: 10/21/2022]
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44
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Sparing R, Thimm M, Hesse MD, Küst J, Karbe H, Fink GR. Bidirectional alterations of interhemispheric parietal balance by non-invasive cortical stimulation. Brain 2009; 132:3011-20. [PMID: 19528092 DOI: 10.1093/brain/awp154] [Citation(s) in RCA: 216] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- R Sparing
- Department of Neurology, University Hospital Cologne, Kerpenerstr. 62, 50924 Cologne, Germany.
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45
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Salillas E, Granà A, Juncadella M, Rico I, Semenza C. Leftward motion restores number space in neglect. Cortex 2009; 45:730-7. [DOI: 10.1016/j.cortex.2008.09.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Revised: 04/21/2008] [Accepted: 09/28/2008] [Indexed: 11/25/2022]
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46
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Somatoparaphrenia: a body delusion. A review of the neuropsychological literature. Exp Brain Res 2008; 192:533-51. [PMID: 18813916 DOI: 10.1007/s00221-008-1562-y] [Citation(s) in RCA: 272] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2008] [Accepted: 08/27/2008] [Indexed: 10/21/2022]
Abstract
A review of published brain-damaged patients showing delusional beliefs concerning the contralesional side of the body (somatoparaphrenia) is presented. Somatoparaphrenia has been reported, with a few exceptions, in right-brain-damaged patients, with motor and somatosensory deficits, and the syndrome of unilateral spatial neglect. Somatoparaphrenia, most often characterized by a delusion of disownership of left-sided body parts, may however occur without associated anosognosia for motor deficits, and personal neglect. Also somatosensory deficits may not be a core pathological mechanism of somatoparaphrenia, and visual field disorders may be absent. Deficits of proprioception, however, may play a relevant role. Somatoparaphrenia is often brought about by extensive right-sided lesions, but patients with posterior (parietal-temporal), and insular damage are on record, as well as a few patients with subcortical lesions. Possible pathological factors include a deranged representation of the body concerned with ownership, mainly right-hemisphere-based, and deficits of multisensory integration. Finally, the rubber hand illusion, that brings about a bodily misattribution in neurologically unimpaired participants, as somatoparaphrenia does in brain-damaged patients, is briefly discussed.
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47
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Schröder A, Wist ER, Hömberg V. TENS and optokinetic stimulation in neglect therapy after cerebrovascular accident: a randomized controlled study. Eur J Neurol 2008; 15:922-7. [DOI: 10.1111/j.1468-1331.2008.02229.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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48
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Abstract
Traumatic minor cervical strains are common place in high-impact sports (e.g. tackling) and premature degenerative changes have been documented in sports people exposed to recurrent impact trauma (e.g. scrummaging in rugby) or repetitive forces (e.g. Formula 1 racing drivers, jockeys). While proprioceptive exercises have been an integral part of rehabilitation of injuries in the lower limb, they have not featured as prominently in the treatment of cervical injuries. However, head and neck position sense (HNPS) testing and re-training may have relevance in the management of minor sports-related neck injuries, and play a role in reducing the incidence of ongoing pain and problems with function. For efficacious programmes to be developed and tested, fundamental principles associated with proprioception in the cervical spine should be considered. Hence, this article highlights the importance of anatomical structures in the cervical spine responsible for position sense, and how their interaction with the CNS affects our ability to plan and execute effective purposeful movements. This article includes a review of studies examining position sense in subjects with and without pathology and describes the effects of rehabilitation programmes that have sought to improve position sense. In respect to the receptors providing proprioceptive information for the CNS, the high densities and complex arrays of spindles found in cervical muscles suggest that these receptors play a key role. There is some evidence suggesting that ensemble encoding of discharge patterns from muscle spindles is relayed to the CNS and that a pattern recognition system is used to establish joint position and movement. Sensory information from neck proprioceptive receptors is processed in tandem with information from the vestibular system. There are extensive anatomical connections between neck proprioceptive inputs and vestibular inputs. If positional information from the vestibular system is inaccurate or fails to be appropriately integrated in the CNS, errors in head position may occur, resulting in an inaccurate reference for HNPS, and conversely if neck proprioceptive information is inaccurate, then control of head position may be affected. The cerebellum and cortex also play a role in control of head position, providing feed-forward and modulatory influences depending on the task requirements. Position-matching tasks have been the most popular means of testing position sense in the cervical spine. These allow the appreciation of absolute, constant and variable errors in positioning and have been shown to be reliable. The results of such tests indicate that errors are relatively low (2-5 degrees). It is apparent that error is not consistently affected by age, a finding similar to studies undertaken in peripheral joints. Furthermore, the range of motion in which subjects are tested does not consistently affect accuracy in a predictable manner. However, it is evident that impairments in position sense are observed in individuals who have experienced whiplash-type injuries and individuals with chronic head and neck pain of non-traumatic origin (e.g. cervical spondylosis). While researchers advocate comprehensive retraining protocols, which include eye and neck motion targeting tasks and coordination exercises, as well as co-contraction exercises to reduce such impairments, some studies show that more general exercises and manipulation may be of benefit. Overall, there is limited information concerning the efficacy of treatment programmes.
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Affiliation(s)
- Bridget Armstrong
- Health and Rehabilitation Research Centre, Auckland University of Technology, Auckland, New Zealand
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49
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Chokron S, Dupierrix E, Tabert M, Bartolomeo P. Experimental remission of unilateral spatial neglect. Neuropsychologia 2007; 45:3127-48. [PMID: 17889040 DOI: 10.1016/j.neuropsychologia.2007.08.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2006] [Revised: 07/18/2007] [Accepted: 08/02/2007] [Indexed: 11/20/2022]
Abstract
Over the past several decades a growing amount of research has focused on the possibility of transiently reducing left neglect signs in right brain-damaged patients by using vestibular and/or visuo-proprioceptive stimulations. Here we review seminal papers dealing with these visuo-vestibulo-proprioceptive stimulations in normal controls, right brain-damaged (RBD) patients, and animals. We discuss these data in terms of clinical implications but also with regards to theoretical frameworks commonly used to explain the unilateral neglect syndrome. We undermine the effect of these stimulations on the position of the egocentric reference and extend the notion that the positive effects of these stimulation techniques may stem from a reorientation of attention towards the neglected side of space or from a recalibration of sensori-motor correlations. We conclude this review with discussing the possible interaction between experimental rehabilitation, models of neglect and basic spatial cognition research.
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Affiliation(s)
- Sylvie Chokron
- Laboratoire de Psychologie et NeuroCognition, CNRS, UMR5105, UPMF, Grenoble, France.
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Abstract
Brain-damaged patients with lesion or dysfunction involving the parietal cortex may show a variety of neuropsychological impairments involving spatial cognition. The more frequent and disabling deficit is the syndrome of unilateral spatial neglect that, in a nutshell, consists in a bias of spatial representation and attention ipsilateral to of extrapersonal, personal (ie, the body) space, or both, toward the side of the hemispheric lesion. The deficit is more frequent and severe after damage to the right hemisphere, involving particularly the posterior-inferior parietal cortex at the temporo-parietal junction. Damage to these posterior parietal regions may also impair visuospatial short-term memory, which may be associated with and worsen spatial neglect. The neural network supporting spatial representation, attention and short-term memory is, however, more extensive, including the right premotor cortex. Also disorders of drawing and building objects (traditionally termed constructional apraxia) are a frequent indicator of posterior parietal damage in the left and in the right hemispheres. Other less frequent deficits, which, however, have a relevant localizing value, include optic ataxia (namely, the defective reaching of visual objects, in the absence of elementary visuo-motor impairments), which is typically brought about by damage to the superior parietal lobule. Optic ataxia, together with deficits of visual attention, of estimating distances and depth, and with apraxia of gaze, constitutes the severely disabling Balint-Holmes' syndrome, which is typically associated with bilateral posterior parietal and occipital damage. Finally, lesions of the posterior parietal lobule (angular gyrus) in the left hemisphere may bring about a tetrad of symptoms (left-right disorientation, acalculia, finger agnosia, and agraphia) termed Gerstmann's syndrome, that also exists in a developmental form.
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Affiliation(s)
- Giuseppe Vallar
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.
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