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Tomé de la Torre MÁ, Álvarez Fernández-Balbuena A, Bernárdez-Vilaboa R, Vázquez Molini D. Artificial Vision System on Digital Devices for Real-Time Head Tilt Control. SENSORS (BASEL, SWITZERLAND) 2024; 24:3756. [PMID: 38931537 PMCID: PMC11207385 DOI: 10.3390/s24123756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/30/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024]
Abstract
It is common to see cases in which, when performing tasks in close vision in front of a digital screen, the posture or position of the head is not adequate, especially in young people; it is essential to have a correct posture of the head to avoid visual, muscular, or joint problems. Most of the current systems to control head inclination require an external part attached to the subject's head. The aim of this study is the validation of a procedure that, through a detection algorithm and eye tracking, can control the correct position of the head in real time when subjects are in front of a digital device. The system only needs a digital device with a CCD receiver and downloadable software through which we can detect the inclination of the head, indicating if a bad posture is adopted due to a visual problem or simply inadequate visual-postural habits, alerting us to the postural anomaly to correct it.The system was evaluated in subjects with disparate interpupillary distances, at different working distances in front of the digital device, and at each distance, different tilt angles were evaluated. The system evaluated favorably in different lighting environments, correctly detecting the subjects' pupils. The results showed that for most of the variables, particularly good absolute and relative reliability values were found when measuring head tilt with lower accuracy than most of the existing systems. The evaluated results have been positive, making it a considerably inexpensive and easily affordable system for all users. It is the first application capable of measuring the head tilt of the subject at their working or reading distance in real time by tracking their eyes.
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Affiliation(s)
| | | | - Ricardo Bernárdez-Vilaboa
- Optics II (Optometry and Vision), Faculty of Optics and Optometry, Complutense University, 28037 Madrid, Spain;
| | - Daniel Vázquez Molini
- Optics Department, Faculty of Optics and Optometry, Complutense University, 28037 Madrid, Spain; (A.Á.F.-B.); (D.V.M.)
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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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Impact of Depression on Cognitive Function and Disease Severity in Idiopathic Cervical Dystonia Patients: One-Center Data in Cross-Sectional Study. Medicina (B Aires) 2022; 58:medicina58121793. [PMID: 36556995 PMCID: PMC9781028 DOI: 10.3390/medicina58121793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/27/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Background: Cervical dystonia is a highly disabling hyperkinetic movement disorder with a lot of nonmotor symptoms. One symptom with a high prevalence is depression, which may negatively affect dystonia patients. The aim of the study was to investigate the impact of depression on disease severity and cognitive functions in cervical dystonia patients. Methods: Patients with cervical dystonia were interviewed and divided into two groups, based on the Patient Health Questionnaire-9: those with no depression or mild depressive features and those with moderate, moderately severe, and severe depression. The severity of dystonia and cognitive functions were assessed and compared in both groups. Results: A total of 52 patients were investigated. Self-assessment of the disease was more negative in clinically significant depressive signs group (p = 0.004), with a tendency for patients with clinically significant depressive features to have a slightly higher score on objective dystonia scales (TSUI and TWSTRS), but without statistically significant differences (p = 0.387 and p = 0.244, respectively). Although not statistically significant, a slightly higher MoCA scale score was registered in cervical dystonia patients with clinically insignificant depressive signs. There was a tendency for worse results in the abstraction category in patients with clinically significant depression (p = 0.056). Conclusions: Patients with clinically significant depression have a more negative self-assessment of the disease and perform worse in abstraction tasks.
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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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Bastos MSC, Nickel R, Camargo CHF, Teive HAG. Patients with Cervical Dystonia Demonstrated Decreased Cognitive Abilities and Visual Planning Compared to Controls. Mov Disord Clin Pract 2021; 8:904-910. [PMID: 34405098 DOI: 10.1002/mdc3.13259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Cervical dystonia (CD) involves clinical and motor manifestations, and visual and cognitive dysfunctions may also be frequent. Objective To evaluate functional vision, visual attention, and cognitive aspects in patients with CD compared with a control group. Methods Fifty patients with CD were assessed using the Useful Field of View Test (UFOV), the Mini Mental State Examination (MMSE), and the Trail Making Tests (TMT-A and TMT-B), and compared with an identical number of health controls matched by sex, age, and educational level. Results No differences were seen between the groups in terms of MMSE score (P = 0.481), but the CD patient group had poorer scores for the TMA-A (P = 0.004) and TMT-B (P = 0.004). For the UFOV subtests, a decrease was found for visual processing speed (P < 0.001), divided attention (P < 0.001), and selective attention (P = 0.001), as well as higher frequency in the categories with higher risk index in the UFOV test (P < 0.001). Conclusion Patients with CD may exhibit decreased functional vision and visual attention, as well as higher risk in performing complex activities.
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Affiliation(s)
- Marina S C Bastos
- Neurological Diseases Group, Graduate Program in Internal Medicine, Internal Medicine Department, Hospital de Clínicas Federal University of Paraná Curitiba Brazil.,Occupational Therapy Department Federal University of Paraná Curitiba Brazil
| | - Renato Nickel
- Occupational Therapy Department Federal University of Paraná Curitiba Brazil
| | - Carlos H F Camargo
- Neurological Diseases Group, Graduate Program in Internal Medicine, Internal Medicine Department, Hospital de Clínicas Federal University of Paraná Curitiba Brazil
| | - Hélio A G Teive
- Neurological Diseases Group, Graduate Program in Internal Medicine, Internal Medicine Department, Hospital de Clínicas Federal University of Paraná Curitiba Brazil.,Movement Disorders Unit, Neurology Service, Internal Medicine Department Hospital de Clínicas, Federal University of Paraná Curitiba Brazil
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Boyce MJ, McCambridge AB, Bradnam LV, Canning CG, Mahant N, Chang FCF, Fung VSC, Verhagen AP. A cross-sectional study of walking, balance and upper limb assessment scales in people with cervical dystonia. J Neural Transm (Vienna) 2021; 128:1663-1675. [PMID: 34333693 DOI: 10.1007/s00702-021-02388-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Abstract
Cervical dystonia (CD) is a neurological movement disorder causing the neck to move involuntarily away from the neutral position. CD is a network disorder, involving multiple brain areas and, therefore, may impair movement in parts of the body other than the neck. This study used clinical assessments to investigate walking, balance and upper limb function (UL) in people with CD; the reliability of scoring these assessments and examined for relationship between CD severity, usual exercise and clinical assessments. We conducted a prospective observational cohort study of participants with isolated, focal, idiopathic CD. Participants were assessed by experienced physiotherapists and completed three questionnaires and eight clinical assessments of fear of falling, balance confidence, walking, balance, UL function and usual exercise. Results were compared to published data from healthy adults and other neurological populations. Twenty-two people with mild to moderate CD participated. Fear of falling, gross UL function and usual exercise were worse in people with CD compared with healthy adults, while walking, balance and distal UL function were similar to healthy populations. All assessments were reliably performed by physiotherapists, and we found no correlations between the severity of dystonia or usual exercise and performance on the physical assessments. Routine performance of clinical assessment of walking and balance are likely not required in people with mild to moderate CD; however, fear of falling and gross upper limb function should be assessed to determine any problems which may be amenable to therapy.
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Affiliation(s)
- M J Boyce
- Graduate School of Health, University of Technology Sydney, Sydney, Australia. .,Physiotherapy Department, Westmead Hospital, Hawkesbury Road, Westmead, NSW, 2145, Australia.
| | - A B McCambridge
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - L V Bradnam
- Department of Exercise Sciences, The University of Auckland, Auckland, New Zealand
| | - C G Canning
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - N Mahant
- Movement Disorders Unit, Westmead Hospital, Sydney, Australia
| | - F C F Chang
- Movement Disorders Unit, Westmead Hospital, Sydney, Australia
| | - V S C Fung
- Movement Disorders Unit, Westmead Hospital, Sydney, Australia
| | - A P Verhagen
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
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Bradnam LV, Meiring RM, Boyce M, McCambridge A. Neurorehabilitation in dystonia: a holistic perspective. J Neural Transm (Vienna) 2020; 128:549-558. [PMID: 33099684 PMCID: PMC8099801 DOI: 10.1007/s00702-020-02265-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 10/09/2020] [Indexed: 01/12/2023]
Abstract
Rehabilitation for isolated forms of dystonia, such as cervical or focal hand dystonia, is usually targeted towards the affected body part and focuses on sensorimotor control and motor retraining of affected muscles. Recent evidence, has revealed people who live with dystonia experience a range of functional and non-motor deficits that reduce engagement in daily activities and health-related quality of life, which should be addressed with therapeutic interventions. These findings support the need for a holistic approach to the rehabilitation of dystonia, where assessment and treatments involve non-motor signs and symptoms, and not just the dystonic body part. Most studies have investigated Cervical Dystonia, and in this population, it is evident there is reduced postural control and walking speed, high fear of falling and actual falls, visual compensation for the impaired neck posture, and a myriad of non-motor symptoms including pain, fatigue, sleep disorders and anxiety and depression. In other populations of dystonia, there is also emerging evidence of falls and reduced vision-related quality of life, along with the inability to participate in physical activity due to worsening of dystonic symptoms during or after exercise. A holistic approach to dystonia would support the management of a wide range of symptoms and signs, that if properly addressed could meaningfully reduce disability and improve quality of life in people living with dystonia.
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Affiliation(s)
- Lynley V Bradnam
- Department of Exercise Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand.
| | - Rebecca M Meiring
- Department of Exercise Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Melani Boyce
- Graduate School of Health, Discipline of Physiotherapy, University of Technology, Sydney, NSW, Australia.,Department of Physiotherapy, Westmead Hospital, Sydney, NSW, Australia
| | - Alana McCambridge
- Graduate School of Health, Discipline of Physiotherapy, University of Technology, Sydney, NSW, Australia
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Martino D, Bonassi G, Lagravinese G, Pelosin E, Abbruzzese G, Avanzino L. Defective Human Motion Perception in Cervical Dystonia Correlates With Coexisting Tremor. Mov Disord 2020; 35:1067-1071. [DOI: 10.1002/mds.28017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/25/2020] [Accepted: 02/09/2020] [Indexed: 01/24/2023] Open
Affiliation(s)
- Davide Martino
- Department of Clinical Neurosciences, Hotchkiss Brain InstituteMathison Mental Health Centre and Alberta Children's Hospital Research Institute, University of Calgary Calgary Canada
| | - Gaia Bonassi
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze MotorieUniversity of Genova Genova Italy
| | - Giovanna Lagravinese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child HealthUniversity of Genova Genova Italy
| | - Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child HealthUniversity of Genova Genova Italy
| | - Giovanni Abbruzzese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child HealthUniversity of Genova Genova Italy
| | - Laura Avanzino
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze MotorieUniversity of Genova Genova Italy
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