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O'Connor S, Hevey D, Burke T, Rafee S, Pender N, O'Keeffe F. A Systematic Review of Cognition in Cervical Dystonia. Neuropsychol Rev 2024; 34:134-154. [PMID: 36696021 PMCID: PMC10920436 DOI: 10.1007/s11065-022-09558-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 04/17/2022] [Accepted: 06/10/2022] [Indexed: 01/26/2023]
Abstract
Growing evidence points to a spectrum of non-motor symptoms, including cognitive difficulties that have a greater impact on functional outcomes and quality of life than motor symptoms in cervical dystonia (CD). Some cognitive impairments have been reported; however, findings are inconsistent, and described across mixed groups of dystonia. The current review aimed to examine the evidence for cognitive impairments in CD. MEDLINE, EMBASE, PsychINFO and Web of Science databases were searched. Studies were included if they met the following criteria (i) cross-sectional or longitudinal studies of adults with CD, (ii) where the results of standardised measures of cognitive or neuropsychological function in any form were assessed and reported, (iii) results compared to a control group or normative data, and (iv) were published in English. Results are presented in a narrative synthesis. Twenty studies were included. Subtle difficulties with general intellectual functioning, processing speed, verbal memory, visual memory, visuospatial function, executive function, and social cognition were identified while language, and attention and working memory appear to be relatively spared. Several methodological limitations were identified that should be considered when interpreting the evidence to describe a specific profile of cognitive impairment in CD. Clinical and research implications are discussed.
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Affiliation(s)
- Sarah O'Connor
- Department of Clinical Psychology, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Dublin, Ireland.
| | - David Hevey
- Department of Clinical Psychology, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Dublin, Ireland
| | - Tom Burke
- Department of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Shameer Rafee
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine & Health Science, University College Dublin, Dublin, Ireland
| | - Niall Pender
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Fiadhnait O'Keeffe
- Department of Clinical Psychology, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Dublin, Ireland
- Department of Psychology, St Vincent's University Hospital, Dublin, Ireland
- School of Psychology, University College Dublin, Dublin, Ireland
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2
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Gammeri R, Schintu S, Salatino A, Vigna F, Mazza A, Gindri P, Barba S, Ricci R. Effects of prism adaptation and visual scanning training on perceptual and response bias in unilateral spatial neglect. Neuropsychol Rehabil 2024; 34:155-180. [PMID: 36652376 DOI: 10.1080/09602011.2022.2158876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 12/11/2022] [Indexed: 01/19/2023]
Abstract
In some patients with unilateral spatial neglect, symptoms reflect impaired lateralized spatial attention and representation (perceptual bias) whereas in others the inability to respond to stimuli located in contralesional space (response bias). Here, we investigated whether prismatic adaptation (PA) and visual scanning training (VST) differentially affect perceptual and response bias and whether rehabilitation outcome depends on the type of bias underlying symptoms. Two groups of neglect patients in the subacute phase were evaluated before, immediately after, and two weeks following 10 days of PA (n = 9) or VST (n = 9). Standard neuropsychological tests (i.e., Behavioural Inattentional Test, Diller cancellation test, and Line Bisection test) were administered to assess neglect symptoms, while the Landmark task was used to disentangle perceptual and response biases. Performance on the Landmark task revealed that PA was more effective in improving the perceptual bias, while VST mainly modulated the response bias. Neuropsychological tests performance suggested that VST is better suited to modulate neglect in patients with response bias, while PA may be effective in patients with both types of bias. These findings may offer novel insights into the efficacy of PA and VST in the rehabilitation of perceptual and response biases in patients with neglect.
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Affiliation(s)
- Roberto Gammeri
- Department of Psychology, University of Turin, Torino, Italy
| | - Selene Schintu
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Adriana Salatino
- Department of Psychology, University of Turin, Torino, Italy
- Institute of Neuroscience (IONS), Université Catholique de Louvain, Bruxelles, Belgium
| | - Francesca Vigna
- Department of Psychology, University of Turin, Torino, Italy
| | | | - Patrizia Gindri
- Service of Neuropsychological Rehabilitation, Presidio Sanitario San Camillo, Torino, Italy
| | - Sonia Barba
- Department of Psychology, University of Turin, Torino, Italy
| | - Raffaella Ricci
- Department of Psychology, University of Turin, Torino, Italy
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Cuinat J, Debû B, Meoni S, Pelissier P, Castrioto A, Fraix V, Moro E. Spatiotemporal Gait Differences before and after Botulinum Toxin in People with Focal Dystonia: A Pilot Study. Mov Disord Clin Pract 2024; 11:143-151. [PMID: 38386480 PMCID: PMC10883397 DOI: 10.1002/mdc3.13944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 10/13/2023] [Accepted: 11/05/2023] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The impact of focal dystonia on gait has attracted little attention and remains elusive. Considering the importance of both visual and head control in gait, blepharospasm and cervical dystonia should affect gait. Improvement of cervical/eyelid control following botulinum toxin (BTX) injections would translate into gait changes. OBJECTIVES To assess gait differences in people with focal dystonia before and after BTX treatment. METHODS Ten patients with blepharospasm, 10 patients with cervical dystonia, and 20 healthy age- and gender-matched controls were included. Gait was assessed before and 1-month after BTX injections using Biodex Gait Trainer™ 3. Gait velocity, cadence, step length, step asymmetry, and variability of step length were compared between patients and controls, and between the two time-points using non-parametric statistics. RESULTS At baseline, compared to controls, cervical dystonia patients showed reduced gait velocity, step length, and cadence. After BTX injections, while gait velocity and step length were significantly increased and step length variability reduced, gait parameters still differed between patients and controls. In blepharospasm patients, baseline gait velocity and step length were significantly smaller than in controls. After BTX injections, these gait parameters were significantly increased and variability decreased, so that patients no longer differed from controls. CONCLUSION Gait differences exist between patients with focal dystonia not directly affecting the lower limbs and healthy controls. These gait abnormalities were improved differently by BTX treatment according to the type of dystonia. These disparities suggest different pathophysiological mechanisms and support the need for changes in rehabilitation routines in cervical dystonia.
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Affiliation(s)
| | - Bettina Debû
- University Grenoble Alpes, Grenoble Institute of Neuroscience, INSERM 1216GrenobleFrance
| | - Sara Meoni
- Division of NeurologyCHU of GrenobleGrenobleFrance
- University Grenoble Alpes, Grenoble Institute of Neuroscience, INSERM 1216GrenobleFrance
| | | | - Anna Castrioto
- Division of NeurologyCHU of GrenobleGrenobleFrance
- University Grenoble Alpes, Grenoble Institute of Neuroscience, INSERM 1216GrenobleFrance
| | - Valérie Fraix
- Division of NeurologyCHU of GrenobleGrenobleFrance
- University Grenoble Alpes, Grenoble Institute of Neuroscience, INSERM 1216GrenobleFrance
| | - Elena Moro
- Division of NeurologyCHU of GrenobleGrenobleFrance
- University Grenoble Alpes, Grenoble Institute of Neuroscience, INSERM 1216GrenobleFrance
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Salatino A, Zavattaro C, Gammeri R, Cirillo E, Piatti ML, Pyasik M, Serra H, Pia L, Geminiani G, Ricci R. Virtual reality rehabilitation for unilateral spatial neglect: A systematic review of immersive, semi-immersive and non-immersive techniques. Neurosci Biobehav Rev 2023; 152:105248. [PMID: 37247829 DOI: 10.1016/j.neubiorev.2023.105248] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 05/31/2023]
Abstract
INTRODUCTION In recent decades, new virtual reality (VR)-based protocols have been proposed for the rehabilitation of Unilateral Spatial Neglect (USN), a debilitating disorder of spatial awareness. However, it remains unclear which type of VR protocol and level of VR immersion can maximize the clinical benefits. To answer these questions, we conducted a systematic review of the use of VR for the rehabilitation of USN. METHOD Studies between 2000 and 2022 that met the inclusion criteria were classified according to their research design and degree of immersion (non-immersive, NIVR; semi-immersive, SIVR; immersive, IVR). RESULTS A total of 375 studies were identified, of which 26 met the inclusion criteria. Improvements were found in 84.6% of the reviewed studies: 85.7% used NIVR, 100% used SIVR and 55.6% used IVR. However, only 42.3% of them included a control group and only 19.2% were randomized control trials (RCT). CONCLUSION VR protocols may offer new opportunities for USN rehabilitation, although further RCTs are needed to validate their clinical efficacy.
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Affiliation(s)
- Adriana Salatino
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; SAN Lab (Space Attention and Action), Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; Department of Life Sciences, Royal Military Academy, Hobbema 8, 1000 Brussels, Belgium
| | - Claudio Zavattaro
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; SAN Lab (Space Attention and Action), Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy
| | - Roberto Gammeri
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; SAN Lab (Space Attention and Action), Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy
| | - Emanuele Cirillo
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; SAN Lab (Space Attention and Action), Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy
| | - Maria Luisa Piatti
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy
| | - Maria Pyasik
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, Italy
| | - Hilary Serra
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; SAN Lab (Space Attention and Action), Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy
| | - Lorenzo Pia
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, Italy; NIT - Neuroscience Institute of Turin, Via Verdi, 8, 10124 Turin, Italy
| | - Giuliano Geminiani
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; NIT - Neuroscience Institute of Turin, Via Verdi, 8, 10124 Turin, Italy
| | - Raffaella Ricci
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; SAN Lab (Space Attention and Action), Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; NIT - Neuroscience Institute of Turin, Via Verdi, 8, 10124 Turin, Italy.
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Odorfer TM, Yabe M, Hiew S, Volkmann J, Zeller D. Topological differences and confounders of mental rotation in cervical dystonia and blepharospasm. Sci Rep 2023; 13:6026. [PMID: 37055560 PMCID: PMC10102235 DOI: 10.1038/s41598-023-33262-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/11/2023] [Indexed: 04/15/2023] Open
Abstract
Mental rotation (mR) bases on imagination of actual movements. It remains unclear whether there is a specific pattern of mR impairment in focal dystonia. We aimed to investigate mR in patients with cervical dystonia (CD) and blepharospasm (BS) and to assess potential confounders. 23 CD patients and 23 healthy controls (HC) as well as 21 BS and 19 hemifacial spasm (HS) patients were matched for sex, age, and education level. Handedness, finger dexterity, general reaction time, and cognitive status were assessed. Disease severity was evaluated by clinical scales. During mR, photographs of body parts (head, hand, or foot) and a non-corporal object (car) were displayed at different angles rotated within their plane. Subjects were asked to judge laterality of the presented image by keystroke. Both speed and correctness were evaluated. Compared to HC, CD and HS patients performed worse in mR of hands, whereas BS group showed comparable performance. There was a significant association of prolonged mR reaction time (RT) with reduced MoCA scores and with increased RT in an unspecific reaction speed task. After exclusion of cognitively impaired patients, increased RT in the mR of hands was confined to CD group, but not HS. While the question of whether specific patterns of mR impairment reliably define a dystonic endophenotype remains elusive, our findings point to mR as a useful tool, when used carefully with control measures and tasks, which may be capable of identifying specific deficits that distinguish between subtypes of dystonia.
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Affiliation(s)
- Thorsten M Odorfer
- Department of Neurology, University of Würzburg, 97080, Würzburg, Germany.
| | - Marie Yabe
- Department of Neurology, University of Würzburg, 97080, Würzburg, Germany
| | - Shawn Hiew
- Department of Neurology, University of Würzburg, 97080, Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University of Würzburg, 97080, Würzburg, Germany
| | - Daniel Zeller
- Department of Neurology, University of Würzburg, 97080, Würzburg, Germany
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Yao D, O'Flynn LC, Simonyan K. DystoniaBoTXNet: Novel Neural Network Biomarker of Botulinum Toxin Efficacy in Isolated Dystonia. Ann Neurol 2023; 93:460-471. [PMID: 36440757 DOI: 10.1002/ana.26558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Isolated dystonia is characterized by abnormal, often painful, postures and repetitive movements due to sustained or intermittent involuntary muscle contractions. Botulinum toxin (BoTX) injections into the affected muscles are the first line of therapy. However, there are no objective predictive markers or standardized tests of BoTX efficacy that can be utilized for appropriate candidate selection prior to treatment initiation. METHODS We developed a deep learning algorithm, DystoniaBoTXNet, which uses a 3D convolutional neural network architecture and raw structural brain magnetic resonance images (MRIs) to automatically discover and test a neural network biomarker of BoTX efficacy in 284 patients with 4 different forms of focal dystonia, including laryngeal dystonia, blepharospasm, cervical dystonia, and writer's cramp. RESULTS DystoniaBoTXNet identified clusters in superior parietal lobule, inferior and middle frontal gyri, middle orbital gyrus, inferior temporal gyrus, corpus callosum, inferior fronto-occipital fasciculus, and anterior thalamic radiation as components of the treatment biomarker. These regions are known to contribute to both dystonia pathophysiology across a broad clinical spectrum of disorder and the central effects of botulinum toxin treatment. Based on its biomarker, DystoniaBoTXNet achieved an overall accuracy of 96.3%, with 100% sensitivity and 86.1% specificity, in predicting BoTX efficacy in patients with isolated dystonia. The algorithmic decision was computed in 19.2 seconds per case. INTERPRETATION DystoniaBoTXNet and its treatment biomarker have a high translational potential as an objective, accurate, generalizable, fast, and cost-effective algorithmic platform for enhancing clinical decision making for BoTX treatment in patients with isolated dystonia. ANN NEUROL 2023;93:460-471.
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Affiliation(s)
- Dongren Yao
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA
| | - Lena C O'Flynn
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA.,Program in Speech Hearing Bioscience and Technology, Harvard University, Boston, MA
| | - Kristina Simonyan
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA.,Program in Speech Hearing Bioscience and Technology, Harvard University, Boston, MA.,Department of Neurology, Massachusetts General Hospital, Boston, MA
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Bailey GA, Martin E, Peall KJ. Cognitive and Neuropsychiatric Impairment in Dystonia. Curr Neurol Neurosci Rep 2022; 22:699-708. [PMID: 36201146 PMCID: PMC9633506 DOI: 10.1007/s11910-022-01233-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW To review recent literature evaluating psychiatric and cognitive symptoms in dystonia, the two non-motor symptom groups most frequently evaluated in dystonia research and recognised in clinical practice. RECENT FINDINGS Recent work has embedded clinical recognition of psychiatric symptoms in dystonia, with depressive and anxiety-related symptoms routinely observed to be the most common. Less explored symptoms, such as self-harm, suicidal ideation, and substance abuse, represent newer areas of investigation, with initial work suggesting higher rates than the background population. Investigation of cognitive function has provided less consistent results, both within individual dystonia subtypes and across the spectrum of dystonias, partly reflecting the heterogeneity in approaches to assessment. However, recent work indicates impairments of higher cognitive function, e.g. social cognition, and disrupted visual and auditory sensory processing. Dystonia demonstrates psychiatric and cognitive symptom heterogeneity, with further work needed to recognise endophenotypes and improve diagnostic accuracy, symptom recognition, and management.
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Affiliation(s)
- Grace A Bailey
- Neuroscience and Mental Health Research Institute, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Eva Martin
- School of Medicine, Cardiff University, Cardiff, UK
| | - Kathryn J Peall
- Neuroscience and Mental Health Research Institute, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK.
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Liu K, Hou Y, Ou R, Yang T, Yang J, Song W, Zhao B, Shang H. Cognitive impairment in Chinese patients with cervical dystonia. Front Neurol 2022; 13:961563. [PMID: 36188384 PMCID: PMC9523424 DOI: 10.3389/fneur.2022.961563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/29/2022] [Indexed: 11/21/2022] Open
Abstract
Objective Cognitive impairment (CI) in patients with cervical dystonia (CD) has been reported in many studies but with inconsistent findings. We investigated the prevalence, characteristics, and clinical factors related to CI in Chinese patients with CD. Methods Sixty-eight patients with CD and 68 healthy controls (HCs) were included in the study. Demographic and clinical data were investigated. A logistic regression analysis was conducted to discriminate the clinical factors associated with CI in patients with CD. A cluster analysis was performed to explore the different characteristics within the group of CD patients with CI. Results We found that 42 (61.76%) patients with CD had CI. The most frequent CI domain was visuospatial function (39.71%), followed by memory (38.24%), attention/working memory (29.41%), language (25.00%), and executive function (23.53%). CD patients with CI were older, less educated, had an older age of onset, more severe motor symptoms and disability, and experienced more pain than CD patients without CI. The presence of CI in patients with CD was associated with less education (OR = 0.802, p = 0.034) and a higher Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) severity subscore (OR = 1.305, p = 0.001). The cluster analysis identified two different subgroups of patients, one with relatively mild cognitive impairment and the other with relatively severe cognitive impairment. Conclusion CI is relatively common in Chinese patients with CD, with the most common CI domain of the visuospatial function. In the present study, CI in patients with CD was associated with less education and more severe motor symptoms, and patients with CI may be further divided into two subgroups based on different extent and domain of cognitive decline.
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O'Flynn LC, Simonyan K. Short- and Long-term Central Action of Botulinum Neurotoxin Treatment in Laryngeal Dystonia. Neurology 2022; 99:e1178-e1190. [PMID: 35764404 PMCID: PMC9536744 DOI: 10.1212/wnl.0000000000200850] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/28/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Laryngeal dystonia (LD) is isolated task-specific focal dystonia selectively impairing speech production. The first choice of LD treatment is botulinum neurotoxin (BoNT) injections into the affected laryngeal muscles. However, whether BoNT has a lasting therapeutic effect on disorder pathophysiology is unknown. We investigated short-term and long-term effects of BoNT treatment on brain function in patients with LD. METHODS A total of 161 participants were included in the functional MRI study. Statistical analyses examined central BoNT effects in patients with LD who were stratified based on the effectiveness and duration of treatment. RESULTS Patients with LD who were treated and benefited from BoNT injections had reduced activity in the left precuneus compared with BoNT-naive and treatment nonbenefiting patients. In addition, BoNT-treated patients with adductor LD had decreased activity in the right thalamus, whereas BoNT-treated abductor patients with LD had reduced activity in the left inferior frontal cortex. No statistically significant differences in brain activity were found between patients with shorter (1-5 years) and longer (13-28 years) treatment durations. However, patients with intermediate treatment duration of 6-12 years showed reduced activity in the right cerebellum compared with patients with both shorter and longer treatment durations and reduced activity in the right prefrontal cortex compared with patients with shorter treatment duration. DISCUSSION Our findings suggest that the left precuneus is the site of short-term BoNT central action in patients with LD, whereas the prefrontal-cerebellar axis is engaged in the BoNT response in patients with intermediate treatment duration of 6-12 years. Involvement of these structures points to indirect action of BoNT treatment on the dystonic sensorimotor network through modulation of motor sequence planning and coordination.
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Affiliation(s)
- Lena C O'Flynn
- From the Department of Otolaryngology-Head and Neck Surgery (L.C.O., K.S.), Massachusetts Eye and Ear and Harvard Medical School; Program in Speech Hearing Bioscience and Technology (L.C.O., K.S.), Harvard University; and Department of Neurology (K.S.), Massachusetts General Hospital, Boston
| | - Kristina Simonyan
- From the Department of Otolaryngology-Head and Neck Surgery (L.C.O., K.S.), Massachusetts Eye and Ear and Harvard Medical School; Program in Speech Hearing Bioscience and Technology (L.C.O., K.S.), Harvard University; and Department of Neurology (K.S.), Massachusetts General Hospital, Boston.
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Xia K, Han Y, Zhou L, Hu S, Rao R, Shan S, Hua L. Attention impairment in patients with cervical dystonia: An attention network test study. Front Psychol 2022; 13:952567. [PMID: 35992456 PMCID: PMC9386253 DOI: 10.3389/fpsyg.2022.952567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022] Open
Abstract
Objective The purpose of this study was to investigate attentional network functional characteristics in patients with cervical dystonia (CD). Methods A total of 29 patients with CD and 26 healthy controls (HCs) were recruited. All subjects participated in the study and underwent the Attention Network Test (ANT), which evaluated the efficiencies of three independent attention networks (alerting, orienting, and executive control), as well as reaction time (RT) and accuracy. Results Significant differences between CD patients (9.86 ± 27.95 ms) and HCs (33.62 ± 23.41 ms) were observed in the alerting network (t = −3.40, p < 0.05). In contrast, the orienting network (t = 0.26, p = 0.79), executive control network (Z = −0.55, p = 0.58), total mean reaction time (t = −2.6, p = 0.79), and total accuracy rate (Z = −1.67, p = 0.09) showed no significant differences between the two groups. Conclusion Patients with CD showed a significant deficit in the alerting network. However, they did not show any deficits in the orienting or executive control network. In addition, the alerting, orienting, and executive control network functions of CD patients were all affected by the severity of torticollis, especially the alerting network function.
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Affiliation(s)
- Kun Xia
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Yongsheng Han
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
- Department of Neurology, Anhui Hospital of Integrated Traditional Chinese and Western Medicine, Hefei, China
- *Correspondence: Yongsheng Han,
| | - Lanlan Zhou
- Department of Neurology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Sheng Hu
- School of Medical Information Engineering, Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Rao Rao
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Shu Shan
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Lei Hua
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
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Biases of Temporal Duration Judgements in Visual and Auditory System. PSYCH 2022. [DOI: 10.3390/psych4030033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: There is evidence that temporal duration is spatially represented on a horizontal mental timeline (MTL) with relatively short durations represented on the left and long duration on the right side. Most of this evidence comes from the visual domain. Objective: With the present study, we investigated whether temporal duration judgements of visual and auditory stimuli might be affected by spatial biases in time representation. Methods: Participants were asked to estimate the temporal duration of a target with respect to a reference stimulus. Two different exposure times were used for the reference (fast and slow), and three exposure times for the target with respect to the reference (shorter, equal, longer). Two versions of the task were implemented to probe visual and auditory temporal processing. Results: Participants showed enhanced performance when the target had longer duration than the reference independently of the type of task, but they were affected in opposite ways by the reference exposure time, in the two tasks. Best performance was observed for the fast reference in the visual domain and for the slow reference in the auditory one. Discussion: We argue that these findings provide evidence that temporal judgments of visual and auditory stimuli are affected by the duration of the reference stimulus, besides the duration of the target stimulus. Interestingly, they suggest putative leftward and rightward spatial biases in time representation for the visual and auditory domains, respectively, although future studies are necessary to further investigate these initial findings.
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Quartarone A, Ghilardi MF. Neuroplasticity in dystonia: Motor symptoms and beyond. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:207-218. [PMID: 35034735 DOI: 10.1016/b978-0-12-819410-2.00031-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This chapter first focuses on the role of altered neuroplasticity mechanisms and their regulation in the genesis of motor symptoms in the various forms of dystonia. In particular, a review of the available literature about focal dystonia suggests that use-dependent plasticity may become detrimental and produce dystonia when practice and repetition are excessive and predisposing conditions are present. Interestingly, recent evidence also shows that functional or psychogenic dystonia, despite the normal plasticity in the sensorimotor system, is characterized by plasticity-related dysfunction within limbic regions. Finally, this chapter reviews the non-motor symptoms that often accompany the motor features of dystonia, including depression and anxiety as well as obsessive-compulsive disorders, pain, and cognitive dysfunctions. Based on the current understanding of these symptoms, we discuss the evidence of their possible relationship to maladaptive plasticity in non-motor basal ganglia circuits involved in their genesis.
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Affiliation(s)
- Angelo Quartarone
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
| | - Maria Felice Ghilardi
- Department of Molecular, Cellular, and Biomedical Sciences, City University of New York School of Medicine and Neuroscience Program, Graduate Center of the City University of New York, New York, NY, United States
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13
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Conson M, Santangelo G, Impallomeni R, Silvestre F, Peluso S, Esposito M. Spatial and egocentric mental rotation in patients with cervical dystonia. J Neurol 2020; 267:2281-2287. [PMID: 32307583 DOI: 10.1007/s00415-020-09839-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 12/26/2022]
Abstract
Mental rotation has attracted the interest of cognitive research on dystonia, but at the moment, contrasting data are available on whether this complex cognitive ability is impaired in the disorder. Here, we assessed spatial and egocentric mental rotation in patients with cervical dystonia (CD). Patients with CD and healthy controls were required to perform a letter rotation task (spatial mental rotation) and to judge laterality of front-facing and back-facing human images (egocentric mental rotation). CD patients were selectively impaired on letter rotation, whereas they did not differ from controls when judging laterality of both front-facing and back-facing bodies. These findings support the view according to which neural circuits involved in spatial processing are dysfunctional in CD.
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Affiliation(s)
- Massimiliano Conson
- Developmental Neuropsychology Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Viale Ellittico 31, 81100, Caserta, Italy.
| | - Gabriella Santangelo
- Developmental Neuropsychology Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Viale Ellittico 31, 81100, Caserta, Italy
| | - Rita Impallomeni
- Developmental Neuropsychology Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Viale Ellittico 31, 81100, Caserta, Italy
| | - Francesco Silvestre
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | | | - Marcello Esposito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy.,Clinical Neurophysiology Unit, Cardarelli Hospital, Naples, Italy
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14
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Assessment of hand functions in patients with idiopathic cervical dystonia. Hum Mov Sci 2020; 70:102581. [PMID: 31950896 DOI: 10.1016/j.humov.2020.102581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 11/23/2019] [Accepted: 01/08/2020] [Indexed: 12/18/2022]
Abstract
Cervical dystonia (CD) is the most common form of focal dystonia characterized by involuntary contractions of the neck muscles, causing abnormal rotation of the head into specific directions. Studies report that idiopathic dystonia is a developmental disorder of the sensorimotor circuits, involving both the cortico-striatal and thalamo-cortical pathways. It is also suggested that enhanced cortical plasticity extends beyond the clinically affected region and may also be detected in the unaffected upper limbs of the patient with CD. In the present study, we aimed at exploring if patients with CD had hand motor dysfunctions. Forty patients with idiopathic CD and 40 healthy controls were included in this study. Dystonic symptoms were assessed by means of The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Stanford Health Assessment Questionnaire (HAQ) was used to assess functional status. Quality of life (QoL) was assessed by using the Medical Outcomes Study Short Form 36-Item Health Survey (SF 36). Grip strength was assessed by using hand dynamometers. Tip pinch, lateral pinch and chuck pinch of the hand were assessed by using a pinchmeter. Fingertip dexterity and hand coordination was assessed using Purdue Pegboard. Duruoz Hand Index (DHI) was used for the assessment of hand functions. There were no significant differences between the groups in grip and pinch strengths of hands and fingers. As to the fingertip dexterity, patients with CD had a mean Pin 1 and Pin 2 test score of 10.6 ± 2.8 and 10.8 ± 3.2 respectively and a mean assembling test score of 5.2 ± 2.0. These results were significantly worse than those of the healthy controls. As to the SF 36 sub-scores, there were significant differences between the groups in all SF 36 sub-scores (p < .001). This study indicates that patients with CD suffer a deteriorated fine motor coordination of hands without dystonic involvement of upper extremities. Furthermore, lower SF 36 scores in patients with CD suggest poorer health-related quality of life.
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15
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Salatino A, Chillemi G, Gontero F, Poncini M, Pyasik M, Berti A, Ricci R. Transcranial Magnetic Stimulation of Posterior Parietal Cortex Modulates Line-Length Estimation but Not Illusory Depth Perception. Front Psychol 2019; 10:1169. [PMID: 31191393 PMCID: PMC6540782 DOI: 10.3389/fpsyg.2019.01169] [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: 12/15/2018] [Accepted: 05/03/2019] [Indexed: 11/13/2022] Open
Abstract
Transcranial Magnetic Stimulation (TMS) may affect attentional processing when applied to the right posterior parietal cortex (PPC) of healthy participants in line with neuropsychological and neuroimaging evidence on the neural bases of this cognitive function. Specifically, the application of TMS to right PPC induces a rightward attentional bias on line length estimation in healthy participants (i.e., neglect-like bias), mimicking the rightward bias shown by patients with unilateral spatial neglect after damage of the right PPC. With the present study, we investigated whether right PPC might play a crucial role in attentional processing of illusory depth perception, given the evidence that a rightward bias may be observed in patients with neglect during perception of the Necker Cube (NC). To this end, we investigated the effects of low-frequency rTMS applied to the right or left PPC on attentional disambiguation of the NC in two groups of healthy participants. To control for the effectiveness of TMS on visuospatial attention, rTMS effects were also assessed on a frequently used line length estimation (i.e., the Landmark Task or LT). Both groups also received sham stimulation. RTMS of the right or left PPC did not affect NC perception. On the other hand, rTMS of the right PPC (but not left PPC) induces neglect-like bias on the LT, in line with previous studies. These findings confirm that right PPC is involved in deployment of spatial attention on line length estimation. Interestingly, they suggest that this brain region does not critically contribute to deployment of visuospatial attention during attentional disambiguation of the Necker Cube. Future investigations, targeting different areas of fronto-parietal circuits, are necessary to further explore the neuro-functional bases of attentional contribution to illusory depth perception.
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Affiliation(s)
- Adriana Salatino
- SpAtial, Motor and Bodily Awareness Research Group, Department of Psychology, University of Turin, Turin, Italy
| | | | - Federica Gontero
- SpAtial, Motor and Bodily Awareness Research Group, Department of Psychology, University of Turin, Turin, Italy
| | - Marisa Poncini
- SpAtial, Motor and Bodily Awareness Research Group, Department of Psychology, University of Turin, Turin, Italy
| | - Maria Pyasik
- SpAtial, Motor and Bodily Awareness Research Group, Department of Psychology, University of Turin, Turin, Italy
| | - Anna Berti
- SpAtial, Motor and Bodily Awareness Research Group, Department of Psychology, University of Turin, Turin, Italy.,Neuroscience Institute of Turin, Turin, Italy
| | - Raffaella Ricci
- SpAtial, Motor and Bodily Awareness Research Group, Department of Psychology, University of Turin, Turin, Italy.,Neuroscience Institute of Turin, Turin, Italy
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16
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Chillemi G, Calamuneri A, Quartarone A, Terranova C, Salatino A, Cacciola A, Milardi D, Ricci R. Endogenous orientation of visual attention in auditory space. J Adv Res 2019; 18:95-100. [PMID: 30828479 PMCID: PMC6383076 DOI: 10.1016/j.jare.2019.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 11/24/2022] Open
Abstract
Facilitation was observed for right-sided auditory stimuli in a new visuo-audio task. Auditory space has dynamic nature, which adapts to changes in visual space. Sound localization was enhanced by visual cues. Crossmodal links in spatial attention were found between audition and vision. These findings have theoretical and translational implications for future studies.
Visuospatial attention is asymmetrically distributed with a leftward bias (i.e. pseudoneglect), while evidence for asymmetries in auditory spatial attention is still controversial. In the present study, we investigated putative asymmetries in the distribution of auditory spatial attention and the influence that visual information might have on its deployment. A modified version of the Posner task (i.e. the visuo-audio spatial task [VAST]) was used to investigate spatial processing of auditory targets when endogenous orientation of spatial attention was mediated by visual cues in healthy adults. A line bisection task (LBT) was also administered to assess the presence of a leftward bias in deployment of visuospatial attention. Overall, participants showed rightward and leftward biases in the VAST and the LBT, respectively. In the VAST, sound localization was enhanced by visual cues. Altogether, these findings support the existence of a facilitation effect for auditory targets originating from the right side of space and provide new evidence for crossmodal links in endogenous spatial attention between vision and audition.
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Affiliation(s)
- Gaetana Chillemi
- IRCCS Centro Neurolesi Bonino Pulejo, Contrada Casazza, SS113, 98124 Messina, Italy
| | | | - Angelo Quartarone
- IRCCS Centro Neurolesi Bonino Pulejo, Contrada Casazza, SS113, 98124 Messina, Italy.,Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Gazzi, 98125 Messina, Italy
| | - Carmen Terranova
- Department of Clinical and Experimental Medicine, Endocrinology, University of Messina, Via Consolare Valeria 1, Gazzi, 98125 Messina, Italy
| | - Adriana Salatino
- Department of Psychology, University of Torino, Torino 10123, Italy
| | - Alberto Cacciola
- IRCCS Centro Neurolesi Bonino Pulejo, Contrada Casazza, SS113, 98124 Messina, Italy.,Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Gazzi, 98125 Messina, Italy
| | - Demetrio Milardi
- IRCCS Centro Neurolesi Bonino Pulejo, Contrada Casazza, SS113, 98124 Messina, Italy.,Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Gazzi, 98125 Messina, Italy
| | - Raffaella Ricci
- Department of Psychology, University of Torino, Torino 10123, Italy
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17
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Bradnam L, Chen C, Graetz L, Loetscher T. Reduced vision-related quality of life in people living with dystonia. Disabil Rehabil 2018; 42:1556-1560. [PMID: 30545271 DOI: 10.1080/09638288.2018.1528636] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose: Dystonia is a neurological movement disorder with negative impact on function and quality of life. It is currently unclear whether vision-related quality of life is affected. The aim of this study was to determine whether vision-related quality of life is reduced by dystonia.Materials and methods: A vision-related quality of life questionnaire was delivered online to probe visual function in people living with dystonia. Scores for each of six domains were compared to normative data of 819 healthy participants using one sample t-tests. Respondents were divided into two groups based on whether they had botulinum toxin injections and compared using independent samples t-tests.Results: There were 42 completed responses. There was a difference from norm for two domains; ocular symptoms (t(41) = 2.31, p = 0.026) and role performance (t(41) = 2.85, p = 0.007). There was variation in responses for all six domains. No difference in scores for the botulinum toxin injection group was found for either domain (both p > 0.74).Conclusions: Some people with dystonia experience reduced vision-related quality of life, which has potential to contribute to their disability. Health professionals should be aware of vision-related issues when managing people with dystonia and consider appropriate rehabilitative interventions to reduce disability and enhance quality of life.Implications for rehabilitationDystonia is a neurological movement disorder resulting in abnormal postures and movements.Vision-related quality of life is reduced by dystonia which may contribute to disability and reduced function.Strategies to improve vision-related quality of life should be included in rehabilitation programmes for people living with dystonia.
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Affiliation(s)
- Lynley Bradnam
- Department of Exercise Science, University of Auckland, Auckland, New Zealand.,Discipline of Physiotherapy, University of Technology Sydney, Sydney, Australia
| | - Celia Chen
- Department of Ophthalmology, Flinders Medical Centre and Flinders University, Adelaide, Australia
| | - Lynton Graetz
- Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
| | - Tobias Loetscher
- School of Psychology, University of South Australia, Adelaide, Australia
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18
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Palermo S, Salatino A, Romagnolo A, Zibetti M, Chillemi G, Lopiano L. Preliminary evidence from a Line-Bisection Task for visuospatial neglect in Parkinson's disease. Parkinsonism Relat Disord 2018; 54:113-115. [PMID: 29628330 DOI: 10.1016/j.parkreldis.2018.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 03/25/2018] [Accepted: 04/01/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Sara Palermo
- Department of Neuroscience, University of Turin, Via Cherasco 15, 10126 Turin, Italy
| | - Adriana Salatino
- SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, Department of Psychology, University of Turin, Via Po 14, Turin, Italy.
| | - Alberto Romagnolo
- Department of Neuroscience, University of Turin, Via Cherasco 15, 10126 Turin, Italy
| | - Maurizio Zibetti
- Department of Neuroscience, University of Turin, Via Cherasco 15, 10126 Turin, Italy
| | - Gaetana Chillemi
- IRCCS Centro Neurolesi "BoninoPulejo", S.S. 113, Via Palermo, C.da Casazza, 98124 Messina, Italy
| | - Leonardo Lopiano
- Department of Neuroscience, University of Turin, Via Cherasco 15, 10126 Turin, Italy
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