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Knights E, McIntosh RD, Ford C, Buckingham G, Rossit S. Peripheral and bimanual reaching in a stroke survivor with left visual neglect and extinction. Neuropsychologia 2024; 201:108901. [PMID: 38704116 DOI: 10.1016/j.neuropsychologia.2024.108901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 04/23/2024] [Accepted: 05/01/2024] [Indexed: 05/06/2024]
Abstract
Whether attentional deficits are accompanied by visuomotor impairments following posterior parietal lesions has been debated for quite some time. This single-case study investigated reaching in a stroke survivor (E.B.) with left visual neglect and visual extinction following right temporo-parietal-frontal strokes. Unlike most neglect patients, E.B. did not present left hemiparesis, homonymous hemianopia nor show evidence of motor neglect or extinction allowing us to examine, for the first time, if lateralised attentional deficits co-occur with deficits in peripheral and bimanual reaching. First, we found a classic optic ataxia field effect: E.B.'s accuracy was impaired when reaching to peripheral targets in her neglected left visual field (regardless of the hand used). Second, we found a larger bimanual cost for movement time in E.B. than controls when both hands reached to incongruent locations. E.B.'s visuomotor profile is similar to the one of patients with optic ataxia showing that attentional deficits are accompanied by visuomotor deficits in the affected field.
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Affiliation(s)
- Ethan Knights
- Neuropsychology Laboratory, School of Psychology, University of East Anglia, Norwich, NR4 7TJ, United Kingdom
| | - Robert D McIntosh
- Human Cognitive Neuroscience, Department of Psychology, The University of Edinburgh, EH8 9JZ, United Kingdom
| | - Catherine Ford
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, United Kingdom
| | - Gavin Buckingham
- Department of Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
| | - Stéphanie Rossit
- Neuropsychology Laboratory, School of Psychology, University of East Anglia, Norwich, NR4 7TJ, United Kingdom.
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2
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Embrechts E, Loureiro-Chaves R, Nijboer TCW, Lafosse C, Truijen S, Saeys W. The Association of Personal Neglect with Motor, Activities of Daily Living, and Participation Outcomes after Stroke: A Systematic Review. Arch Clin Neuropsychol 2024; 39:249-264. [PMID: 37591497 DOI: 10.1093/arclin/acad063] [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] [Accepted: 07/08/2023] [Indexed: 08/19/2023] Open
Abstract
Despite its potential clinical impact, the association of personal neglect (PN) with motor, activities of daily living (ADL), and participation outcomes after stroke is not well-understood. This first-ever systematic review on the topic therefore evaluates this association, taking into account suggested subtypes of PN, including body representation neglect, somatosensory neglect, motor neglect, and premotor neglect. A systematic literature search was conducted on February 17, 2023 in PubMed, Web of Science, Scopus, PubPsych, and PsycArticles databases. The study adheres to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and its protocol was registered on PROSPERO (CRD42020187460). Eleven observational studies were included, gathering 1,400 individuals after stroke (429 showed PN). Results show that individuals with body representation neglect after stroke have significantly decreased movement control and motor strength, lower functional mobility, and ADL independency compared with those without body representation neglect after stroke. Individuals with motor neglect after stroke showed worse motor function and spasticity than to those without motor neglect after stroke. Nonspecified PN (i.e., PN evaluated with an outcome measure that does not allow subcategorization) was related to worse lateropulsion with pushing, longer length of stay and greater odds of being discharged to somewhere other than home. No study evaluated somatosensory and premotor neglect. This review highlights the limited research in this area and emphasizes the need for a more comprehensive PN assessment. However, currently available assessment tools show limited ability to accurately diagnose PN subtypes and future research should prioritize the development of comprehensive diagnostic test batteries.
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Affiliation(s)
- Elissa Embrechts
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Renata Loureiro-Chaves
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Tanja C W Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Christophe Lafosse
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Steven Truijen
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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Moore MJ, Driscoll R, Colwell M, Hewitt O, Demeyere N. Aligning formal and functional assessments of Visuospatial Neglect: A mixed-methods study. Neuropsychol Rehabil 2022; 32:2560-2579. [PMID: 34392812 DOI: 10.1080/09602011.2021.1967172] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
ABSTRACTThe occurrence of visuospatial neglect acts as a key predictor of recovery outcome following stroke. However, the specific behavioural profiles associated with various neglect subtypes are not well understood. This study aims to identify real-world functional impairments associated with neglect, to determine whether functional impairment profiles differ across patients with egocentric and allocentric neglect, and to investigate how neglect severity predicts functional impairments.Notes from 290 stroke patients' occupational therapy functional assessments were qualitatively and quantitatively analysed in the context of neglect type and severity as reported by the OCS Cancellation Task. Overall, neglect patients had more references to having difficulty initiating tasks, finding items, exhibiting spatial inattention, and having difficulty using both arms than patients without neglect. The proportion of theme references did not differ significantly across patients with egocentric and allocentric neglect. The quantitative severity of egocentric neglect was acted as a significant predictor of reference occurrence over and above stroke severity within difficulty finding items, spatial inattention, body inattention, and upper limb use.This study expands on previous findings by identifying real-world functional impairments differentiating patients with and without neglect. This data provides novel insight into the impact of neglect on functional abilities.
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Affiliation(s)
- Margaret Jane Moore
- Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
| | - Rebecca Driscoll
- Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
| | - Michael Colwell
- Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
| | - Olivia Hewitt
- Oxford Institute of Clinical Psychology Training and Research, Isis Education Centre, Warneford Hospital, Oxford, UK
| | - Nele Demeyere
- Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
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Object-centered sensorimotor bias of torque control in the chronic stage following stroke. Sci Rep 2022; 12:14539. [PMID: 36008561 PMCID: PMC9411611 DOI: 10.1038/s41598-022-18754-z] [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: 03/18/2022] [Accepted: 08/18/2022] [Indexed: 11/08/2022] Open
Abstract
When lifting objects whose center of mass (CoM) are not centered below the handle one must compensate for arising external torques already at lift-off to avoid object tilt. Previous studies showed that finger force scaling during object lifting may be impaired at both hands following stroke. However, torque control in object manipulation has not yet been studied in patients with stroke. In this pilot study, thirteen patients with chronic stage left hemispheric stroke (SL), nine patients with right hemispheric stroke (SR) and hand-matched controls had to grasp and lift an object with the fingertips of their ipsilesional hand at a handle while preventing object tilt. Object CoM and therewith the external torque was varied by either relocating a covert weight or the handle. The compensatory torque at lift-off (Tcom) is the sum of the torque resulting from (1) grip force being produced at different vertical finger positions (∆CoP × GF) and (2) different vertical load forces on both sides of the handle (∆Fy × w/2). When having to rely on sensorimotor memories, ∆CoP × GF was elevated when the object CoM was on the ipsilesional-, but decreased when CoM was on the contralesional side in SL, whereas ∆Fy × w/2 was biased in the opposite direction, resulting in normal Tcom. SR patients applied a smaller ∆CoP × GF when the CoM was on the contralesional side. Torques were not altered when geometric cues were available. Our findings provide evidence for an object-centered spatial bias of manual sensorimotor torque control with the ipsilesional hand following stroke reminiscent of premotor neglect. Both intact finger force-to-position coordination and visuomotor control may compensate for the spatial sensorimotor bias in most stroke patients. Future studies will have to confirm the found bias and evaluate the association with premotor neglect.
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From Hemispheric Asymmetry through Sensorimotor Experiences to Cognitive Outcomes in Children with Cerebral Palsy. Symmetry (Basel) 2022. [DOI: 10.3390/sym14020345] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Recent neuroimaging studies allowed us to explore abnormal brain structures and interhemispheric connectivity in children with cerebral palsy (CP). Behavioral researchers have long reported that children with CP exhibit suboptimal performance in different cognitive domains (e.g., receptive and expressive language skills, reading, mental imagery, spatial processing, subitizing, math, and executive functions). However, there has been very limited cross-domain research involving these two areas of scientific inquiry. To stimulate such research, this perspective paper proposes some possible neurological mechanisms involved in the cognitive delays and impairments in children with CP. Additionally, the paper examines the ways motor and sensorimotor experience during the development of these neural substrates could enable more optimal development for children with CP. Understanding these developmental mechanisms could guide more effective interventions to promote the development of both sensorimotor and cognitive skills in children with CP.
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From Patient to Musician: A Multi-Sensory Virtual Reality Rehabilitation Tool for Spatial Neglect. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Unilateral Spatial Neglect (USN) commonly results from a stroke or acquired brain injury. USN affects multiple modalities and results in failure to respond to stimuli on the contralesional side of space. Although USN is a heterogeneous syndrome, present-day therapy methods often fail to consider multiple modalities. Musical Neglect Therapy (MNT) is a therapy method that succeeds in incorporating multiple modalities by asking patients to make music. This research aimed to exploit the immersive and modifiable aspect of VR to translate MNT to a VR therapy tool. The tool was evaluated in a 2-week pilot study with four clinical users. These results are compared to a control group of four non-clinical users. Results indicated that patients responded to triggers in their entire environment and performance results could be clearly differentiated between clinical and non-clinical users. Moreover, patients increasingly corrected their head direction towards their neglected side. Patients stated that the use of VR increased their enjoyment of the therapy. This study contributes to the current research on rehabilitation for USN by proposing the first system to apply MNT in a VR environment. The tool shows promise as an addition to currently used rehabilitation methods. However, results are limited to a small sample size and performance metrics. Future work will focus on validating these results with a larger sample over a longer period. Moreover, future efforts should explore personalisation and gamification to tailor to the heterogeneity of the condition.
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Moore MJ, Vancleef K, Riddoch MJ, Gillebert CR, Demeyere N. Recovery of Visuospatial Neglect Subtypes and Relationship to Functional Outcome Six Months After Stroke. Neurorehabil Neural Repair 2021; 35:823-835. [PMID: 34269128 PMCID: PMC8414826 DOI: 10.1177/15459683211032977] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background/Objective. This study aims to investigate how complex visuospatial neglect behavioural phenotypes predict long-term outcomes, both in terms of neglect recovery and broader functional outcomes after 6 months post-stroke. Methods. This study presents a secondary cohort study of acute and 6-month follow-up data from 400 stroke survivors who completed the Oxford Cognitive Screen's Cancellation Task. At follow-up, patients also completed the Stroke Impact Scale questionnaire. These data were analysed to identify whether any specific combination of neglect symptoms is more likely to result in long-lasting neglect or higher levels of functional impairment, therefore warranting more targeted rehabilitation. Results. Overall, 98/142 (69%) neglect cases recovered by follow-up, and there was no significant difference in the persistence of egocentric/allocentric (X2 [1] = .66 and P = .418) or left/right neglect (X2 [2] = .781 and P = .677). Egocentric neglect was found to follow a proportional recovery pattern with all patients demonstrating a similar level of improvement over time. Conversely, allocentric neglect followed a non-proportional recovery pattern with chronic neglect patients exhibiting a slower rate of improvement than those who recovered. A multiple regression analysis revealed that the initial severity of acute allocentric, but not egocentric, neglect impairment acted as a significant predictor of poor long-term functional outcomes (F [9,300] = 4.742, P < .001 and adjusted R2 = .098). Conclusions. Our findings call for systematic neuropsychological assessment of both egocentric and allocentric neglect following stroke, as the occurrence and severity of these conditions may help predict recovery outcomes over and above stroke severity alone.
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Affiliation(s)
- Margaret J. Moore
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Kathleen Vancleef
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - M. Jane Riddoch
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | | | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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Wang TN, Liang KJ, Howe TH, Chen HL, Huang CW, Wu CT. Spatial Attention Disregard in Children With Hemiplegic Cerebral Palsy. Am J Occup Ther 2020; 74:7402205090p1-7402205090p9. [PMID: 32204787 DOI: 10.5014/ajot.2020.038851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Children with hemiplegic cerebral palsy (CP) demonstrate spatial attention disregard, but the rehabilitation approach to CP is traditionally motor oriented. OBJECTIVE To explore spatial attention disregard in children with hemiplegic CP and its relationship to their motor performance in daily activities. DESIGN Cross-sectional study. SETTING Community. PARTICIPANTS Twenty-five children with hemiplegic CP and 25 age-matched typically developing children. OUTCOMES AND MEASURES For spatial attention performance, the Random Visual Stimuli Detection Task; for developmental disregard, the Observatory Test of Capacity, Performance, and Developmental Disregard; and for motor performance, the Melbourne Assessment 2. RESULTS Children with hemiplegic CP evidenced spatial attention disregard on their more affected sides, and this phenomenon was correlated with developmental disregard. CONCLUSIONS AND RELEVANCE Children with hemiplegic CP demonstrate developmental disregard in both the motor and the visual-spatial attention domains. Including evaluation of and intervention for visual-spatial attention for children with hemiplegic CP in the traditionally motor-oriented rehabilitation approach is recommended. WHAT THIS ARTICLE ADDS This research provides evidence that children with hemiplegic CP demonstrate disregard in the domain of visual-spatial attention. The findings suggest that evaluation of and intervention for visual-spatial attention should be included in CP rehabilitation in addition to the traditionally motor-oriented approach.
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Affiliation(s)
- Tien-Ni Wang
- Tien-Ni Wang, PhD, is Associate Professor, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan, and Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei City, Taiwan
| | - Kai-Jie Liang
- Kai-Jie Liang, BS, is Doctoral Student, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | - Tsu-Hsin Howe
- Tsu-Hsin Howe, PhD, is Associate Professor, Department of Occupational Therapy, Steinhardt School of Culture, Education and Human Development, New York University, New York
| | - Hao-Ling Chen
- Hao-Ling Chen, PhD, is Associate Professor, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan, and Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei City, Taiwan
| | - Chen-Wei Huang
- Chen-Wei Huang, MS, is Occupational Therapist, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | - Chien-Te Wu
- Chien-Te Wu, PhD, is Assistant Professor, School of Occupational Therapy and Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei City, Taiwan, and Occupational Therapist, Department of Psychiatry, National Taiwan University Hospital, Taipei City, Taiwan;
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Neuropsychological Changes in Complex Regional Pain Syndrome (CRPS). Behav Neurol 2020; 2020:4561831. [PMID: 32399082 PMCID: PMC7201816 DOI: 10.1155/2020/4561831] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/24/2019] [Accepted: 12/11/2019] [Indexed: 01/18/2023] Open
Abstract
Complex Regional Pain Syndrome (CRPS) is a poorly understood chronic pain condition of multifactorial origin. CRPS involves sensory, motor, and autonomic symptoms primarily affecting one extremity. Patients can also present with neuropsychological changes such as reduced attention to the CRPS-affected extremity, reminiscent of hemispatial neglect, yet in the absence of any brain lesions. However, this "neglect-like" framework is not sufficient to characterise the range of higher cognitive functions that can be altered in CRPS. This comprehensive literature review synthesises evidence of neuropsychological changes in CRPS in the context of potential central mechanisms of the disorder. The affected neuropsychological functions constitute three distinct but not independent groups: distorted body representation, deficits in lateralised spatial cognition, and impairment of non-spatially-lateralised higher cognitive functions. We suggest that many of these symptoms appear to be consistent with a broader disruption to parietal function beyond merely what could be considered "neglect-like." Moreover, the extent of neuropsychological symptoms might be related to the clinical signs of CRPS, and rehabilitation methods that target the neuropsychological changes can improve clinical outcomes in CRPS and other chronic pain conditions. Based on the limitations and gaps in the reviewed literature, we provide several suggestions to improve further research on neuropsychological changes in chronic pain.
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Kang TW, Kim BR. Effect of Proprioceptive Neuromuscular Facilitation Chopping Pattern on Neglect, Balance, and Activity of Daily Living of Stroke Patients with Hemi-Spatial Neglect: A randomized clinical trial. ACTA ACUST UNITED AC 2019. [DOI: 10.13066/kspm.2019.14.2.107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Tae-Woo Kang
- Department of Physical Therapy, College of Health and Welfare, Woosuk University
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Iyanaga T, Abe H, Oka T, Miura T, Iwasaki R, Takase M, Isatake M, Doi A. Recumbent cycling with integrated volitional control electrical stimulation improves gait speed during the recovery stage in stroke patients. J Exerc Rehabil 2019; 15:95-102. [PMID: 30899743 PMCID: PMC6416497 DOI: 10.12965/jer.1836500.250] [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: 10/12/2018] [Accepted: 12/09/2018] [Indexed: 12/05/2022] Open
Abstract
The purpose of this study was to investigate the effect of recumbent cycling with integrated volitional control electrical stimulation (IVES) on gait ability in stroke patients. Six stroke patients (all male; average age, 55.7±8.3 years) participated. Recumbent cycling (R-cycling) was performed with and without IVES in the power assist (IVES-P) mode. The targeted muscle for electrostimulation was the tibialis anterior. Patients performed 10 min of IVES-P mode plus R-cycling (program A) or R-cycling alone (program B), once per day, 5 times per week. Patients completed two sets of each program, alternating between programs each week. Gait speed and the number of steps numbers on a 10-m walking test was assessed before and after each interventional session. Program A improved gait speed, but not the number of steps, to a greater extent than that in program B. Specifically, the combined intervention significantly improved gait speed in the first set, but not the second set of the intervention. R-cycling with IVES-P mode improved gait speed during the recovery stage in stroke patients to a greater extent than that achieved with R-cycling alone. Thus, this combined therapy has potential as a standardized treatment in the field of rehabilitation medicine.
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Affiliation(s)
- Takuya Iyanaga
- Department of Rehabilitation, Fukuoka Seisyukai Hospital, Fukuoka, Japan.,Center of Advanced Rehabilitation "HOPE", Fukuoka Seisyukai Hospital, Fukuoka, Japan
| | - Hayata Abe
- Department of Rehabilitation, Fukuoka Seisyukai Hospital, Fukuoka, Japan.,Center of Advanced Rehabilitation "HOPE", Fukuoka Seisyukai Hospital, Fukuoka, Japan
| | - Takashi Oka
- Department of Rehabilitation, Fukuoka Seisyukai Hospital, Fukuoka, Japan.,Center of Advanced Rehabilitation "HOPE", Fukuoka Seisyukai Hospital, Fukuoka, Japan
| | - Tetsuya Miura
- Department of Rehabilitation, Tsutsumi Hospital, Fukuoka, Japan
| | - Rumiko Iwasaki
- Department of Rehabilitation, Fukuoka Seisyukai Hospital, Fukuoka, Japan.,Center of Advanced Rehabilitation "HOPE", Fukuoka Seisyukai Hospital, Fukuoka, Japan
| | - Mai Takase
- Department of Rehabilitation, Fukuoka Seisyukai Hospital, Fukuoka, Japan.,Center of Advanced Rehabilitation "HOPE", Fukuoka Seisyukai Hospital, Fukuoka, Japan
| | - Minoru Isatake
- Department of Rehabilitation, Fukuoka Seisyukai Hospital, Fukuoka, Japan.,Center of Advanced Rehabilitation "HOPE", Fukuoka Seisyukai Hospital, Fukuoka, Japan
| | - Atsushi Doi
- Department of Rehabilitation, Faculty of Health Science, Kumamoto Health Science University, Kumamoto, Japan.,Division of Health Sciences, Graduate School of Health Sciences, Kumamoto Health Science University, Kumamoto, Japan
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Abstract
A review of patients with brain injury showing personal neglect is presented. The aim is to shed light on this aspect of neglect often unresearched or only indirectly investigated, and to discuss recent findings concerning the methods used to assess personal neglect, its neural correlates and its association with the more often explored aspect of extrapersonal neglect. The review was performed using PubMed and PsychInfo databases to search for papers published in the last 123 years (until January 2018). We reviewed 81 papers describing either single or group studies for a total of 2247 patients. The results of this review showed that various aspects of personal neglect are still controversial and outcomes potentially contradictory. Despite the data reported in the present review suggest that personal neglect is more frequently associated with lesions of the right hemisphere, the left hemisphere may also play an important role. Not surprisingly, personal neglect and extrapersonal neglect seem to co-occur. However double dissociations of these two forms of neglect have been reported, and they seem to dissociate both from a functional and an anatomical perspective. More recent interpretations of personal neglect suggest that it may result from a disrupted body representation. The development of reliable psychometric tools with shared diagnostic criteria is essential to identify different degrees of personal neglect for different body parts and to better refine personal neglect in comparison to extrapersonal neglect and disorders related to distortions of personal domain.
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Affiliation(s)
- Pietro Caggiano
- Psychology Department, Goldsmiths University of London, New Cross, London, SE14 6NW, UK.
| | - Mervi Jehkonen
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
- Department of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Finland
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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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Chen P, Pitteri M, Gillen G, Ayyala H. Ask the experts how to treat individuals with spatial neglect: a survey study. Disabil Rehabil 2017; 40:2677-2691. [DOI: 10.1080/09638288.2017.1347720] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Peii Chen
- Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers University, Newark, NJ, USA
| | - Marco Pitteri
- Department of Neurosciences Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Glen Gillen
- Department of Regenerative and Rehabilitation Medicine (Occupational Therapy), Columbia University Medical Center, New York, NY, USA
| | - Harsha Ayyala
- New Jersey Medical School, Rutgers University, Newark, NJ, USA
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Christophe L, Delporte L, Revol P, DePaepe A, Rode G, Jacquin-Courtois S, Rossetti Y. Complex regional pain syndrome associated with hyperattention rather than neglect for the healthy side: A comprehensive case study. Ann Phys Rehabil Med 2016; 59:294-301. [DOI: 10.1016/j.rehab.2016.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 10/18/2016] [Indexed: 11/25/2022]
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17
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Stein MS, Kilbride C, Reynolds FA. What are the functional outcomes of right hemisphere stroke patients with or without hemi-inattention complications? A critical narrative review and suggestions for further research. Disabil Rehabil 2015; 38:315-28. [PMID: 25893401 PMCID: PMC4720036 DOI: 10.3109/09638288.2015.1037865] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Purpose: There is widespread acceptance that patients demonstrating neglect/hemi-inattention (HI) following right hemisphere stroke (RHS) underachieve functionally compared to their counterparts without neglect. However, empirical evidence for this view needs examination. The purpose of this review is to critically appraise relevant studies that compared outcomes from RHS patients with/without hemi-attention and suggest more robust follow-up research. Method: Twelve studies published in 1995–2013 were critically reviewed. Two independent reviewers appraised design features including sample representation, assessment and data analysis methods. Strengths and limitations were highlighted. Results: Results were largely inconsistent. Considerable heterogeneity within patient groups and across studies complicated interpretation. Evidence suggested average group disparity in scores between patients with and without HI at discharge but the cause of functional disparity could not be attributed specifically to HI from the data and modelling results available. Conclusion: The relationship between HI status and functional recovery warrants further investigation in studies with stronger methodology to ensure rigour and robustness in the results. Pending further research, HI status should not be regarded as a key predictor of functional recovery or rehabilitation potential in patients with RHSs. This group should continue to receive appropriate therapeutic intervention aimed at maximising their functional recovery post-stroke.Implications for Rehabilitation Findings from this review demonstrate a paucity of evidence to support the presence of hemi-inattention as a key predictor of functional recovery in patients with right hemisphere stroke; as such, practitioners should take this into consideration when planning rehabilitation programmes of their patients. In the initial months following right hemisphere stroke, there are wide-ranging differences in the rate and amount of functional recovery in patients, with and without hemi-inattention. Practitioners should not limit the aspirations of their patients based on the presence or absence of hemi-inattention. This review has identified a number of measurement limitations in commonly employed assessment tools for hemi-inattention and overall functional recovery. As such, practitioners should take the limitations of specific measures into account when interpreting the results contextually and with respect to their patients’ situation.
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Affiliation(s)
| | - Cherry Kilbride
- a Department of Clinical Sciences , Brunel University , London , UK
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18
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Saevarsson S, Eger S, Gutierrez-Herrera M. Neglected premotor neglect. Front Hum Neurosci 2014; 8:778. [PMID: 25360095 PMCID: PMC4197652 DOI: 10.3389/fnhum.2014.00778] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 09/13/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Styrmir Saevarsson
- Clinical Neuropsychology Research Group (EKN), Department of Neuropsychology, Bogenhausen Academical Hospital Munich, Germany
| | - Simone Eger
- Clinical Neuropsychology Research Group (EKN), Department of Neuropsychology, Bogenhausen Academical Hospital Munich, Germany ; Department of Psychology, University of Innsbruck Innsbruck, Austria
| | - Maria Gutierrez-Herrera
- Clinical Neuropsychology Research Group (EKN), Department of Neuropsychology, Bogenhausen Academical Hospital Munich, Germany ; Department Biology II Neurobiology, Graduate School of Systemic Neurosciences, University of Munich (LMU) Munich, Germany
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19
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Taub E, Mark VW, Uswatte G. Implications of CI therapy for visual deficit training. Front Integr Neurosci 2014; 8:78. [PMID: 25346665 PMCID: PMC4191165 DOI: 10.3389/fnint.2014.00078] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 09/17/2014] [Indexed: 11/29/2022] Open
Abstract
We address here the question of whether the techniques of Constraint Induced (CI) therapy, a family of treatments that has been employed in the rehabilitation of movement and language after brain damage might apply to the rehabilitation of such visual deficits as unilateral spatial neglect and visual field deficits. CI therapy has been used successfully for the upper and lower extremities after chronic stroke, cerebral palsy (CP), multiple sclerosis (MS), other central nervous system (CNS) degenerative conditions, resection of motor areas of the brain, focal hand dystonia, and aphasia. Treatments making use of similar methods have proven efficacious for amblyopia. The CI therapy approach consists of four major components: intensive training, training by shaping, a "transfer package" to facilitate the transfer of gains from the treatment setting to everyday activities, and strong discouragement of compensatory strategies. CI therapy is said to be effective because it overcomes learned nonuse, a learned inhibition of movement that follows injury to the CNS. In addition, CI therapy produces substantial increases in the gray matter of motor areas on both sides of the brain. We propose here that these mechanisms are examples of more general processes: learned nonuse being considered parallel to sensory nonuse following damage to sensory areas of the brain, with both having in common diminished neural connections (DNCs) in the nervous system as an underlying mechanism. CI therapy would achieve its therapeutic effect by strengthening the DNCs. Use-dependent cortical reorganization is considered to be an example of the more general neuroplastic mechanism of brain structure repurposing. If the mechanisms involved in these broader categories are involved in each of the deficits being considered, then it may be the principles underlying efficacious treatment in each case may be similar. The lessons learned during CI therapy research might then prove useful for the treatment of visual deficits.
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Affiliation(s)
- Edward Taub
- University of Alabama at BirminghamBirmingham, AL, USA
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20
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Lima RCM, Nascimento LR, Michaelsen SM, Polese JC, Pereira ND, Teixeira-Salmela LF. Influences of hand dominance on the maintenance of benefits after home-based modified constraint-induced movement therapy in individuals with stroke. Braz J Phys Ther 2014; 18:435-44. [PMID: 25372006 PMCID: PMC4228629 DOI: 10.1590/bjpt-rbf.2014.0050] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 05/05/2014] [Indexed: 11/22/2022] Open
Abstract
Objective: To investigate the influence of hand dominance on the maintenance of gains after
home-based modified constraint-induced movement therapy (mCIMT). Method: Aprevious randomized controlled trial was conducted to examine the addition of
trunk restraint to the mCIMT. Twenty-two chronic stroke survivors with mild to
moderate motor impairments received individual home-based mCIMT with or without
trunk restraints, five times per week, three hours daily over two weeks. In this
study, the participants were separated into dominant group, which had their
paretic upper limb as dominant before the stroke (n=8), and non-dominant group
(n=14) for analyses. The ability to perform unimanual tasks was measured by the
Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL),
whereas the capacity to perform bimanual tasks was measured using the Bilateral
Activity Assessment Scale (BAAS). Results: Analysis revealed significant positive effects on the MAL amount of use and
quality of the movement scales, as well as on the BAAS scores after intervention,
with no differences between groups. Both groups maintained the bimanual
improvements during follow-ups (BAAS-seconds 0.1, 95% CI -10.0 to 10.0), however
only the dominant group maintained the unilateral improvements (MAL-amount of use:
1.5, 95% CI 0.7 to 2.3; MAL-quality: 1.3, 95% CI 0.5 to 2.1). Conclusions: Upper limb dominance did not interfere with the acquisition of upper limb skills
after mCIMT. However, the participants whose paretic upper limb was dominant
demonstrated better abilities to maintain the unilateral gains. The bilateral
improvements were maintained, regardless of upper limb dominance.
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Affiliation(s)
- Renata C M Lima
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Lucas R Nascimento
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Stella M Michaelsen
- Departamento de Fisioterapia, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brasil
| | - Janaine C Polese
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Natália D Pereira
- Departamento de Fisioterapia, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brasil
| | - Luci F Teixeira-Salmela
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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21
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Cheng B, Forkert ND, Zavaglia M, Hilgetag CC, Golsari A, Siemonsen S, Fiehler J, Pedraza S, Puig J, Cho TH, Alawneh J, Baron JC, Ostergaard L, Gerloff C, Thomalla G. Influence of stroke infarct location on functional outcome measured by the modified rankin scale. Stroke 2014; 45:1695-702. [PMID: 24781084 DOI: 10.1161/strokeaha.114.005152] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE In the early days after ischemic stroke, information on structural brain damage from MRI supports prognosis of functional outcome. It is rated widely by the modified Rankin Scale that correlates only moderately with lesion volume. We therefore aimed to elucidate the influence of lesion location from early MRI (days 2-3) on functional outcome after 1 month using voxel-based lesion symptom mapping. METHODS We analyzed clinical and MRI data of patients from a prospective European multicenter stroke imaging study (I-KNOW). Lesions were delineated on fluid-attenuated inversion recovery images on days 2 to 3 after stroke onset. We generated statistic maps of lesion contribution related to clinical outcome (modified Rankin Scale) after 1 month using voxel-based lesion symptom mapping. RESULTS Lesion maps of 101 patients with middle cerebral artery infarctions were included for analysis (right-sided stroke, 47%). Mean age was 67 years, median admission National Institutes of Health Stroke Scale was 11. Mean infarct volumes were comparable between both sides (left, 37.5 mL; right, 43.7 mL). Voxel-based lesion symptom mapping revealed areas with high influence on higher modified Rankin Scale in regions involving the corona radiata, internal capsule, and insula. In addition, asymmetrically distributed impact patterns were found involving the right inferior temporal gyrus and left superior temporal gyrus. CONCLUSIONS In this group of patients with stroke, characteristic lesion patterns in areas of motor control and areas involved in lateralized brain functions on early MRI were found to influence functional outcome. Our data provide a novel map of the impact of lesion localization on functional stroke outcome as measured by the modified Rankin Scale.
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Affiliation(s)
- Bastian Cheng
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.).
| | - Nils Daniel Forkert
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Melissa Zavaglia
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Claus C Hilgetag
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Amir Golsari
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Susanne Siemonsen
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Jens Fiehler
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Salvador Pedraza
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Josep Puig
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Tae-Hee Cho
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Josef Alawneh
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Jean-Claude Baron
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Leif Ostergaard
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Christian Gerloff
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
| | - Götz Thomalla
- From the Department of Neurology (B.C., A.G., C.G., G.T.), Department of Computational Neuroscience (N.D.F., M.Z., C.H.), and Department of Neuroradiology (S.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain (S.P., J.P.); Department of Neurology, Hospices Civils de Lyon, Lyon, France (T.-H.C.); Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (J.A., J.-C.B.); and Department of Neuroradiology, Aarhus University Hospital and Center of Functionally Integrative Neuroscience/MINDLab, Aarhus University, Aarhus, Denmark (L.O.)
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de Vries S, Tepper M, Feenstra W, Oosterveld H, Boonstra AM, Otten B. Motor imagery ability in stroke patients: the relationship between implicit and explicit motor imagery measures. Front Hum Neurosci 2013; 7:790. [PMID: 24312044 PMCID: PMC3832786 DOI: 10.3389/fnhum.2013.00790] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 10/30/2013] [Indexed: 11/23/2022] Open
Abstract
There is little consensus on how motor imagery ability should be measured in stroke patients. In particular it is unclear how two methods tapping different aspects of the motor imagery process relate to each other. The aim of this study was to investigate the relationship between implicit and explicit motor imagery ability by comparing performance of stroke patients and controls on a motor imagery questionnaire and a hand laterality judgment task (HLJT). Sixteen ischemic stroke patients (36 ± 13 weeks post-stroke) and 16 controls, matched by age (51 ± 10 years), gender (7 females) and handedness (3 left-handed), performed a HLJT and completed a motor imagery questionnaire. Our study shows that neither in the healthy controls nor in patients, a correlation is found between the HLJT and the motor imagery questionnaire. Although the patient group scored significantly lower than the control group on the visual motor imagery component (U = 60; p = 0.010) and the kinesthetic motor imagery component (U = 63.5; p = 0.015) of the questionnaire, there were no significant differences between patients and controls on accuracy scores of the HLJT. Analyses of the reaction time profiles of patients and controls showed that patient were still able to use an implicit motor imagery strategy in the HLJT task. Our results show that after stroke performance on tests that measure two different aspects of motor imagery ability, e.g., implicit and explicit motor imagery, can be differently affected. These results articulate the complex relation phenomenological experience and the different components of motor imagery have and caution the use of one tool as an instrument for use in screening, selecting and monitoring stroke patients in rehabilitation settings.
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Affiliation(s)
- Sjoerd de Vries
- Centre for Human Movement Sciences, University Medical Centre Groningen, University of Groningen Groningen, Netherlands ; Research Centre for Health, Social Work & Technology, School of Applied Psychology, Saxion University of Applied Sciences Deventer, Netherlands
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23
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Saevarsson S. Prism adaptation theory in unilateral neglect: motor and perceptual components. Front Hum Neurosci 2013; 7:728. [PMID: 24204338 PMCID: PMC3817368 DOI: 10.3389/fnhum.2013.00728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 10/12/2013] [Indexed: 11/30/2022] Open
Affiliation(s)
- Styrmir Saevarsson
- Clinical Neuropsychology Research Group (EKN), Bogenhausen University Hospital Munich, Germany
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24
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Punt TD, Riddoch MJ, Humphreys GW. Motor extinction: a deficit of attention or intention? Front Hum Neurosci 2013; 7:644. [PMID: 24137119 PMCID: PMC3797439 DOI: 10.3389/fnhum.2013.00644] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 09/17/2013] [Indexed: 11/25/2022] Open
Abstract
Motor extinction refers to a deficit of motor production on the side opposite a brain lesion that either only becomes apparent or disproportionately worsens during bilateral motor activity. It may arise due either to a contralesional deficit in setting the motor activation level (an intentional deficit) or a deficit in contralesional awareness of the sensory consequences of movement (an attentional deficit). In this study, we investigate the nature of motor extinction in a patient (LR) with a right fronto-temporal lesion through the kinematic analysis of unimanual and bimanual circle-drawing movements. While the ipsi- and contralesional limbs performed comparably for unimanual movements, the contralesional limb demonstrated marked bradykinesia and hypometria during bimanual movements. Furthermore, these deficits were not overcome when visual feedback of the contralesional limb was provided (Experiment 1). However, when performing bimanual movements in the presence of a visual template (Experiment 2), LR was able to overcome the contralesional hypometria but not the bradykinesia which proved intractable across both experiments. Both the bradykinesia and hypometria could result from an intentional deficit of motor production. However, in Experiment 2, LR also demonstrated an abnormal level of positional drift in the contralesional limb for bimanual movements indicative of an additional attentional deficit. We conclude that LR’s presentation of motor extinction is the result of a primary intentional deficit and a secondary attentional deficit.
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Affiliation(s)
- T David Punt
- School of Rehabilitation and Health Sciences, Leeds Metropolitan University , Leeds , UK
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25
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Kandel M, Beis JM, Le Ray M, Fraser A, Le Chapelain L, Datié AM, Paysant J. Transcranial direct current stimulation improves function for stroke patients with pure motor neglect: A case report. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Kandel M, Beis JM, Le Ray M, Fraser A, Le Chapelain L, Datié AM, Paysant J. Amélioration d’une négligence motrice post AVC par stimulation transcrânienne par courant continu : à propos d’un cas. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Saevarsson S. Motor Response Deficits of Unilateral Neglect: Assessment, Therapy, and Neuroanatomy. APPLIED NEUROPSYCHOLOGY-ADULT 2013; 20:292-305. [DOI: 10.1080/09084282.2012.710682] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Styrmir Saevarsson
- a Clinical Neuropsychology Research Group (EKN), Bogenhausen University Hospital , Munich , Germany
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Maxton C, Dineen RA, Padamsey RC, Munshi SK. Don't neglect 'neglect'- an update on post stroke neglect. Int J Clin Pract 2013; 67:369-78. [PMID: 23521329 DOI: 10.1111/ijcp.12058] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Post-stroke neglect is common and an independent predictor of functional outcome. Assessment of neglect is very demanding, the treatment extremely difficult and the literature vast; we performed a literature search for all aspects of this difficult subject. METHODS We searched the PubMed, EMBASE databases and historical manuals for authoritative studies on post stroke neglect between 1951 and 2011. FINDINGS There is a great dearth of randomised controlled data on neglect because standardised assessment does not occur frequently. Eighty-eight manuscripts were identified in the literature, which were quite heterogeneous in their content and addressing diverse aspects of this clinical entity. INTERPRETATION AND IMPLICATIONS The most important historical papers were selected along with the most widely accepted and proven strategies for assessment and treatment. Standardised assessment of neglect does not always occur, but several useful strategies are available and are described in the following sections.
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Affiliation(s)
- C Maxton
- Department of Stroke Medicine, Nottingham University Hospital, Nottingham, UK
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Sampanis DS, Riddoch J. Motor neglect and future directions for research. Front Hum Neurosci 2013; 7:110. [PMID: 23544016 PMCID: PMC3610167 DOI: 10.3389/fnhum.2013.00110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 03/14/2013] [Indexed: 11/20/2022] Open
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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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Punt DT, Cooper L, Hey M, Johnson MI. Neglect-like symptoms in complex regional pain syndrome: Learned nonuse by another name? Pain 2013; 154:200-203. [DOI: 10.1016/j.pain.2012.11.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2012] [Revised: 10/05/2012] [Accepted: 11/14/2012] [Indexed: 10/27/2022]
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Sturt R, Punt TD. Caloric vestibular stimulation and postural control in patients with spatial neglect following stroke. Neuropsychol Rehabil 2013; 23:299-316. [PMID: 23305103 DOI: 10.1080/09602011.2012.755831] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The impact of spatial neglect remains a substantial challenge to patients undergoing rehabilitation following stroke. Beyond the relatively well-described implications for visuospatial function, neglect is increasingly shown to have a negative impact on the wider aspects of sensori-motor performance with corresponding implications for activities including gait and balance. Caloric vestibular stimulation (CVS) administered to the contralesional ear has previously been shown to improve performance in patients with spatial neglect. Here, in Experiment One, we investigated the effect of CVS on clinical measures of spatial neglect and postural control in three groups of patients following stroke; left brain damaged patients (LBD, n = 6), right brain damaged patients without neglect (RBD-, n = 6), and right brain damaged patients with neglect (RBD+ , n = 6). While post-stimulation scores demonstrated an improvement for participants with spatial neglect, further analysis of postural scores indicated that improvement was selective for asymmetrical activities, with symmetrical activities remaining unchanged. We interpret these results with reference to the related problem of extinction which predicts that activities demanding synchronous bilateral activity (symmetrical activities) would cause greater difficulties for patients with neglect. In Experiment Two, we tested a further six RBD+ patients on the same measures following CVS to the ipsilesional (right) ear. There was no significant improvement in perceptual or postural scores. Our findings are supportive of previous studies that demonstrate improvement in perception and movement for patients with spatial neglect following contralesional CVS and suggest that these improvements may have clinical benefits.
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Affiliation(s)
- Ruth Sturt
- Stroke Rehabilitation Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK.
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Chen P, McKenna C, Kutlik AM, Frisina PG. Interdisciplinary communication in inpatient rehabilitation facility: evidence of under-documentation of spatial neglect after stroke. Disabil Rehabil 2012; 35:1033-8. [PMID: 23072734 DOI: 10.3109/09638288.2012.717585] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Spatial neglect commonly occurs after stroke and predicts poor rehabilitation outcomes. However, this disorder is under-recognized in clinical practices, which may result from the failure to document its presence. This study aimed to identify the predictors for documentation of spatial neglect in inpatient rehabilitation facilities. METHOD We performed a comprehensive chart review to investigate whether the presence of spatial neglect was documented in 74 neglect patients' clinical notes recorded by physicians, nurses, or occupational therapists (OTs), or in team conference notes. Independent variables included neglect severity, length of stay, Functional Independence Measure at admission and discharge. RESULTS Of the 74 neglect patients, 75.7% were documented by OTs, 63.5% by physicians, and 17.6% by nurses. Although 93.2% of neglect patients were recognized by at least one clinician group, only 31.1% were discussed in multidisciplinary team conferences. Neglect patients who were documented by physicians were more likely to be documented in team conferences. While no factors predicted whether a neglect patient would be documented by nurses or OTs, we found significant predictors for neglect documentation in physician and team conference notes. The odds of being documented by physicians were increasingly greater with poorer efficiency of cognitive rehabilitation (odds ratio = 0.70). The odds of being discussed in team conferences were increasingly greater with more severe neglect (odds ratio = 0.98), and with longer stay in hospitalization (odds ratio = 1.06). CONCLUSIONS Multidisciplinary care may not involve as much interdisciplinary communication as needed to document important disease states. Stroke rehabilitation professionals should be able to recognize spatial neglect independently and document it consistently.
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Affiliation(s)
- Peii Chen
- Kessler Foundation Research Center, West Orange, NJ 07052, USA.
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Garbarini F, Rabuffetti M, Piedimonte A, Pia L, Ferrarin M, Frassinetti F, Gindri P, Cantagallo A, Driver J, Berti A. ‘Moving’ a paralysed hand: bimanual coupling effect in patients with anosognosia for hemiplegia. Brain 2012; 135:1486-97. [PMID: 22374937 DOI: 10.1093/brain/aws015] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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McCabe C. Mirror visual feedback therapy. A practical approach. J Hand Ther 2011; 24:170-8; quiz 179. [PMID: 21106347 DOI: 10.1016/j.jht.2010.08.003] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 08/09/2010] [Accepted: 08/13/2010] [Indexed: 02/03/2023]
Abstract
Mirror visual feedback (MVF) was first proposed as a therapy to relieve amputee phantom limb pain in the early 1990s. It is increasingly used to treat a range of other chronic pain conditions. The evidence base to date is limited. Much of the literature consists of pilot projects or case study designs although larger randomized controlled trails are now emerging. However, the described protocols for MVF are inadequate to adapt to clinical practice. In addition, the therapist sees a heterogeneous population whose characteristics may fall outside those of the tight inclusion/exclusion criteria of research studies. This article provides the theoretical background to MVF and a detailed description of applying this therapy in clinical practice.
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Affiliation(s)
- Candy McCabe
- The Royal National Hospital for Rheumatic Diseases, Bath, UK.
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Pomeroy V, Aglioti SM, Mark VW, McFarland D, Stinear C, Wolf SL, Corbetta M, Fitzpatrick SM. Neurological principles and rehabilitation of action disorders: rehabilitation interventions. Neurorehabil Neural Repair 2011; 25:33S-43S. [PMID: 21613536 DOI: 10.1177/1545968311410942] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This third chapter discusses the evidence for the rehabilitation of the most common movement disorders of the upper extremity. The authors also present a framework, building on the computation, anatomy, and physiology (CAP) model, for incorporating some of the principles discussed in the 2 previous chapters by Frey et al and Sathian et al in the practice of rehabilitation and for discussing potentially helpful interventions based on emergent neuroscience principles.
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Isolated motor neglect following infarction of the posterior limb of the right internal capsule: a case study with diffusion tensor imaging-based tractography. J Neurol 2011; 259:100-5. [DOI: 10.1007/s00415-011-6134-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 05/24/2011] [Accepted: 06/02/2011] [Indexed: 11/26/2022]
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Books. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2010. [DOI: 10.12968/ijtr.2010.17.2.46336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This book provides a wealth of information regarding the theory and practice of evaluating joint motion and muscle length. Chapters are arranged into five sections: 1 - history, basic principles and relevance of joint motion and muscle length assessment, 2 - the upper limb, 3 - the head, neck and trunk, 4 - the lower limb, and 5 - appendices, which contain sample data recording forms and a summary of the research on normative range of motion. Each chapter in sections 2 to 4 is focused on an anatomical area. These chapters provide detailed information on how to evaluate joint range of motion (or muscle length), as well as the anatomy and kinesiology theory that underpins these assessments. For example, chapter 3, ‘Measurement of ROM of the shoulder’ contains information regarding the anatomy, osteokinematics and arthrokinematics of the glenohumeral, sternoclavicular, acromioclavicular and scapulothoracic joints. Limits to motion are discussed and research is presented regarding the motion required to undertake functional activities. Techniques used to evaluate shoulder range of motion are described in detail, and include the patient position, stabilization, examiner action, goniometer alignment, alternative starting positions, and documentation procedures. Photographs are provided to increase the clarity of these descriptions. The chapters on muscle length assessment follow a similar format and all chapters are exhaustively referenced.
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Affiliation(s)
- Valerie M Pomeroy
- Rehabilitation for Older People, Rehabilitation and Ageing, Geriatric Medicine, St George's University of London, UK
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Abstract
Motor neglect, underuse of one side of the body not explained by weakness or sensory impairment, is a common consequence of stroke that is surprisingly little understood. Behavioural and neuroanatomical hallmarks of the disorder are investigated. Using a masked prime task, it was shown that when patients with left motor neglect plan to move their left hand, irrelevant right limb motor programmes intrude, causing delay. Lesion analysis reveals that such asymmetry of motor programming occurs after infarcts of the right putamen and motor association areas. This demonstration of failure to inhibit ipsilesional limb motor plans suggests potential benefit from interventions that might act to restore balance in action planning.
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Affiliation(s)
- E Coulthard
- Institute of Neurology and National Hospital for Neurology and Neurosurgery, 17 Queen Square, London WC1N3AR, UK.
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