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Kertesz A. Anton, Balint, Charles Bonnet, and the Others: The ABC of Cerebral Visual Syndromes (A Historical Guide and an Update). Can J Neurol Sci 2024; 51:300-304. [PMID: 37385640 DOI: 10.1017/cjn.2023.246] [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] [Indexed: 07/01/2023]
Abstract
Cerebral visual impairments have been of great interest to neurologists, ophthalmologists, and neuroscientists. Complicated or partial varieties related to cortical blindness are discussed in this review. They are a fascinating alphabet of eponymic clinical syndromes, bordering neurology, ophthalmology, and even psychiatry. Recent functional imaging and experimental studies have contributed further knowledge of cognitive visual organization in addition to the classical lesion evidence.
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Affiliation(s)
- Andrew Kertesz
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
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2
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Pong MY, Yap JF, Chung TY, Chan SC, Sabirin S. Anton-Babinski Syndrome in a Recurrent Ischemic Stroke Patient: A Case Report. Cureus 2023; 15:e44599. [PMID: 37795056 PMCID: PMC10546808 DOI: 10.7759/cureus.44599] [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] [Accepted: 09/03/2023] [Indexed: 10/06/2023] Open
Abstract
Anton-Babinski syndrome (ABS) is a rare neuropsychiatric condition characterized by visual anosognosia (denial of vision loss) and confabulation in the presence of intact anterior visual tracts. The most common cause of ABS is a cerebrovascular accident involving bilateral occipital lobe injuries with varying degrees of cortical blindness. In this report, we present the case of a woman with suspected ABS following a recurrent ischemic stroke in Malaysia. Establishing a proper diagnosis of stroke is crucial for modifying rehabilitation goals to ensure improved functional outcomes.
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Affiliation(s)
- Mei Yin Pong
- Rehabilitation Medicine, Universiti Malaya, Kuala Lumpur, MYS
- Rehabilitation Medicine, University Malaya Medical Centre, Kuala Lumpur, MYS
| | - Jun Fai Yap
- Social and Preventive Medicine, Universiti Malaya, Kuala Lumpur, MYS
- Public Health, University Malaya Medical Centre, Kuala Lumpur, MYS
| | - Tze Yang Chung
- Rehabilitation Medicine, Universiti Malaya, Kuala Lumpur, MYS
- Rehabilitation Medicine, University Malaya Medical Centre, Kuala Lumpur, MYS
| | - Soo Chin Chan
- Rehabilitation Medicine, Universiti Malaya, Kuala Lumpur, MYS
- Rehabilitation Medicine, University Malaya Medical Centre, Kuala Lumpur, MYS
| | - Sakinah Sabirin
- Rehabilitation Medicine, Universiti Malaya, Kuala Lumpur, MYS
- Rehabilitation Medicine, University Malaya Medical Centre, Kuala Lumpur, MYS
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3
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Omori T, Funayama M, Anamizu S, Ishikawa M, Niida R, Tabuchi H. A Selective Hand Posture Apraxia in an Individual With Posterior Cortical Atrophy and Probable Corticobasal Syndrome. Cogn Behav Neurol 2023; 36:118-127. [PMID: 36961317 DOI: 10.1097/wnn.0000000000000339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 11/09/2022] [Indexed: 03/25/2023]
Abstract
A selective impairment for making hand postures that are required to use specific tools has rarely been reported in individuals with acquired brain injury, and such an impairment has not been documented at all in individuals with degenerative disorders. We describe an individual with posterior cortical atrophy and probable corticobasal syndrome who was unable to use tools because of an inability to make the proper hand posture required for each tool. This individual was, however, able to use the tools properly once her hand postures were corrected, and her ability to manipulate the tools (ie, timing, arm posture, and amplitude) was intact. Also, she had no difficulty with a test of her manipulation knowledge. Areas of hypoperfusion observed by single-photon emission computerized tomography included the anterior intraparietal sulcus in the left parietal lobe, which is an area that has been proposed to control hand postures. This selective impairment might be explained by the reasoning-based hypothesis for apraxia, which attributes hand posture errors in the absence of manipulation errors to dysfunction in one of the three independent pathways that subserve tool use, rather than the manipulation-based hypothesis for apraxia, which attributes hand posture errors to impaired manipulation knowledge. This is the first case with a degenerative disorder that revealed a selective impairment for making hand postures for tool use, which might be explained mainly by apraxia of hand postures along with visuospatial dysfunction (simultanagnosia) and/or sensory disturbance.
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Affiliation(s)
- Tomohiro Omori
- Department of Rehabilitation, International University of Health and Welfare, Narita Hospital, Narita-City, Japan
| | - Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Japan
| | - Sachiko Anamizu
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Mei Ishikawa
- Department of Rehabilitation, Kawagoe Rehabilitation Hospital, Kawagoe-City, Japan
| | - Richi Niida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hajime Tabuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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4
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Werth R. Dyslexia: Causes and Concomitant Impairments. Brain Sci 2023; 13:brainsci13030472. [PMID: 36979282 PMCID: PMC10046374 DOI: 10.3390/brainsci13030472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/07/2023] [Accepted: 03/06/2023] [Indexed: 03/12/2023] Open
Abstract
In recent decades, theories have been presented to explain the nature of dyslexia, but the causes of dyslexia remained unclear. Although the investigation of the causes of dyslexia presupposes a clear understanding of the concept of cause, such an understanding is missing. The present paper proposes the absence of at least one necessary condition or the absence of all sufficient conditions as causes for impaired reading. The causes of impaired reading include: an incorrect fixation location, too short a fixation time, the attempt to recognize too many letters simultaneously, too large saccade amplitudes, and too short verbal reaction times. It is assumed that a longer required fixation time in dyslexic readers results from a functional impairment of areas V1, V2, and V3 that require more time to complete temporal summation. These areas and areas that receive input from them, such as the fusiform gyrus, are assumed to be impaired in their ability to simultaneously process a string of letters. When these impairments are compensated by a new reading strategy, reading ability improves immediately.
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Affiliation(s)
- Reinhard Werth
- Institute for Social Pediatrics and Adolescent Medicine, Ludwig-Maximilians-University of Munich, Haydnstr. 5, D-80336 München, Germany
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5
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Kudo S, Funayama M, Kurose S, Shimizu Y, Takata T, Mimura M. Shadowing Behavior May Be Associated with an Inability to Recognize the External World: A Case Report of Shadowing in a Patient with Posterior Cortical Atrophy. J Alzheimers Dis 2023; 94:1323-1330. [PMID: 37458035 PMCID: PMC10473056 DOI: 10.3233/jad-230257] [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] [Accepted: 06/03/2023] [Indexed: 07/18/2023]
Abstract
Although shadowing behavior- when one individual closely follows another- is routinely documented among patients with dementia, its mechanisms have yet to be elucidated. In particular, there have been no detailed descriptions of patients with shadowing behavior. To propose its potential backgrounds, we describe a patient with posterior cortical atrophy who exhibited prominent shadowing behavior. He also experienced severe difficulties recognizing external stimuli, including visuospatial dysfunction, several types of agnosia, difficulties in verbal comprehension, disorientation, and its associated depression. This shadowing behavior may be adaptive relative to his extreme difficulty with recognizing the world around him.
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Affiliation(s)
- Shun Kudo
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
| | - Shin Kurose
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Yusuke Shimizu
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
- Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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6
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Aboulhosn P, Ryu A, Shafieesabet A, Lekshminarayanan A, Husain S, O'Connor K, D'Souza S, O'Neill S, Altschuler EL. Partial Balint's syndrome and left homonymous hemianopsia presenting after resection of a right occipito-parietal glioblastoma. Neurocase 2022; 28:483-487. [PMID: 36794351 DOI: 10.1080/13554794.2023.2176778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
A 66-year-old left-handed male was admitted to our acute inpatient rehabilitation (AIR) unit following a resection of the right occipito-parietal glioblastoma. He presented with symptoms of horizontal oculomotor apraxia, contralateral optic ataxia and left homonymous hemianopsia. We diagnosed this patient with partial Bálint's syndrome (BS)- oculomotor apraxia, optic ataxia but not simultanagnosia. BS is typically caused by bilateral posterior parietal lesions, but we here describe a unique case due toresection of a right intracranial tumor. A short AIR stay allowed our patient to learn how to compensate for visuomotor and visuospatial deficits, and improved his quality of life significantly.
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Affiliation(s)
- Petra Aboulhosn
- Department of Physical Medicine and Rehabilitation, Metropolitan Hospital, New York, NY, USA
| | - Andrew Ryu
- New York Medical College, Valhalla, NY, USA
| | - Azadeh Shafieesabet
- Department of Rehabilitation Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Anusha Lekshminarayanan
- Department of Physical Medicine and Rehabilitation, Metropolitan Hospital, New York, NY, USA
| | - Sohni Husain
- Department of Physical Medicine and Rehabilitation, Metropolitan Hospital, New York, NY, USA
| | - Kathryn O'Connor
- Department of Physical Medicine and Rehabilitation, Metropolitan Hospital, New York, NY, USA
| | - Saarah D'Souza
- Department of Physical Medicine and Rehabilitation, Metropolitan Hospital, New York, NY, USA
| | - Shannon O'Neill
- Department of Physical Medicine and Rehabilitation, Metropolitan Hospital, New York, NY, USA
| | - Eric L Altschuler
- Department of Physical Medicine and Rehabilitation, Metropolitan Hospital, New York, NY, USA.,Department of Rehabilitation Medicine, New York Medical College, Valhalla, NY, USA
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7
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de Vries SM, Tucha O, Melis-Dankers BJM, Vrijling ACL, Ribbers S, Cornelissen FW, Heutink J. The Birthday Party Test (BPT): A new picture description test to support the assessment of simultanagnosia in patients with acquired brain injury. APPLIED NEUROPSYCHOLOGY. ADULT 2022; 29:383-396. [PMID: 32476466 DOI: 10.1080/23279095.2020.1763998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
There is broad consensus on the utility of complex pictures in the assessment of simultanagnosia in patients with acquired brain injury (ABI). To overcome various shortcomings of current instruments, we have developed the Birthday Party Test (BPT); a picture description test that contains a neutral scene, a balanced representation of events, and provides clear instructions and a scoring-aid. We have applied the BPT in a large group of patients with ABI (n = 502) and in an age-matched healthy control group (n = 194). Our results show that performance on the BPT was associated with a range of descriptive, neuropsychological and clinical characteristics and that poor test performance appeared to be more common in patients with etiologies that have an increased risk of bilateral damage. Furthermore, we assume a high correspondence between test performance on the BPT and the assessor's clinical judgment of likely having simultanagnosia in preliminary analyses. This study shows the potential usefulness of the BPT to support diagnostic decision making in simultanagnosia. The BPT is made freely available to facilitate its broad application in the clinical assessment of patients with visual impairment and to enable a further evaluation of its utility and validity in future studies.
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Affiliation(s)
- S M de Vries
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, The Netherlands
| | - O Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - B J M Melis-Dankers
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, The Netherlands
| | - A C L Vrijling
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, The Netherlands
| | - S Ribbers
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - F W Cornelissen
- Laboratory of Experimental Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J Heutink
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, The Netherlands
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8
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McGinnis SM, Stern AM, Woods JK, Torre M, Feany MB, Miller MB, Silbersweig DA, Gale SA, Daffner KR. Case Study 1: A 55-Year-Old Woman With Progressive Cognitive, Perceptual, and Motor Impairments. J Neuropsychiatry Clin Neurosci 2022; 34:8-15. [PMID: 34763525 PMCID: PMC8813898 DOI: 10.1176/appi.neuropsych.21040114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Scott M. McGinnis
- Department of Neurology, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Andrew M. Stern
- Department of Neurology, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Jared K. Woods
- Department of Pathology, Division of Neuropathology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Matthew Torre
- Department of Pathology, Division of Neuropathology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Mel B. Feany
- Department of Pathology, Division of Neuropathology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Michael B. Miller
- Department of Pathology, Division of Neuropathology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - David A. Silbersweig
- Department of Psychiatry, Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Seth A. Gale
- Department of Neurology, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Kirk R. Daffner
- Department of Neurology, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston
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9
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Frigato G. The Neural Correlates of Access Consciousness and Phenomenal Consciousness Seem to Coincide and Would Correspond to a Memory Center, an Activation Center and Eight Parallel Convergence Centers. Front Psychol 2021; 12:749610. [PMID: 34659068 PMCID: PMC8511498 DOI: 10.3389/fpsyg.2021.749610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/01/2021] [Indexed: 11/23/2022] Open
Abstract
An increasing number of authors suggest that the neural correlates of consciousness (NCC) have no selective, executive, or metacognitive function. It is believed that attention unconsciously selects the contents that will become conscious. Consciousness would have only the fundamental function of transforming the selected contents into a format easily used by high-level processors, such as working memory, language, or autobiographical memory. According to Dehaene, the neural correlates (NC) of access consciousness (AC; cognitive consciousness) constitute a widespread network in the frontal, parietal, and temporal cortices. While Tononi localized the correlates of phenomenal consciousness (PC; subjective consciousness) to a posterior “hot zone” in the temporo-parietal cortex. A careful examination of the works of these two groups leads to the conclusion that the correlates of access and PC coincide. The two consciousnesses are therefore two faces of the same single consciousness with both its cognitive and subjective contents. A review of the literature of the pathology called “neglect” confirms that the common correlates include 10: a memory center, an activation center, and eight parallel centers. From study of the “imagery” it can be deduced that these eight parallel centers would operate as points of convergence in the third person linking the respective eight sensory-motor-emotional areas activated by external perceptions and the corresponding memories of these perceptions deposited in the memory center. The first four centers of convergence appear in the most evolved fish and gradually reach eight in humans.
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10
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Werth R. Is Developmental Dyslexia Due to a Visual and Not a Phonological Impairment? Brain Sci 2021; 11:1313. [PMID: 34679378 PMCID: PMC8534212 DOI: 10.3390/brainsci11101313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022] Open
Abstract
It is a widely held belief that developmental dyslexia (DD) is a phonological disorder in which readers have difficulty associating graphemes with their corresponding phonemes. In contrast, the magnocellular theory of dyslexia assumes that DD is a visual disorder caused by dysfunctional magnocellular neural pathways. The review explores arguments for and against these theories. Recent results have shown that DD is caused by (1) a reduced ability to simultaneously recognize sequences of letters that make up words, (2) longer fixation times required to simultaneously recognize strings of letters, and (3) amplitudes of saccades that do not match the number of simultaneously recognized letters. It was shown that pseudowords that could not be recognized simultaneously were recognized almost without errors when the fixation time was extended. However, there is an individual maximum number of letters that each reader with DD can recognize simultaneously. Findings on the neurobiological basis of temporal summation have shown that a necessary prolongation of fixation times is due to impaired processing mechanisms of the visual system, presumably involving magnocells and parvocells. An area in the mid-fusiform gyrus also appears to play a significant role in the ability to simultaneously recognize words and pseudowords. The results also contradict the assumption that DD is due to a lack of eye movement control. The present research does not support the assumption that DD is caused by a phonological disorder but shows that DD is due to a visual processing dysfunction.
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Affiliation(s)
- Reinhard Werth
- Institute for Social Pediatrics and Adolescent Medicine, University of Munich, Haydnstrasse 5, D-80336 Munich, Germany
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11
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Pehere NK, Dutton GN. Perceptual visual dysfunction in children - An Indian perspective. Indian J Ophthalmol 2021; 69:2004-2011. [PMID: 34304166 PMCID: PMC8482924 DOI: 10.4103/ijo.ijo_1996_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/04/2020] [Accepted: 10/07/2020] [Indexed: 11/25/2022] Open
Abstract
Perceptual visual dysfunction (PVD) comprises a group of vision disorders resulting from dysfunction of the posterior parietal and/or temporal lobes. Often, affected children have normal/near normal visual acuities and/or visual fields, but have difficulties in activities of daily living involving the use of vision. PVDs are known to be common among children with risk factors such as a history of prematurity and/or neurodevelopmental disorders. The inferior temporal lobes and ventral stream transform visual signals into perception, while the posterior parietal lobes and dorsal stream transform visual signals to non-consciously map the scene to guide action and facilitate attention. Dysfunction of these can lead to specific visual impairments that need to be identified during history taking, triggering ascertainment of further details by a structured inventory approach. Clinical tests to elicit dorsal and ventral stream visual dysfunctions have good specificity but low sensitivity. Neuropsychologists are rarely available in the developing world to perform detailed assessments, but there are a few tests that can be used by eye care professionals with some training. Optical coherence tomography (OCT) showing thinning of the ganglion cell layer and retinal nerve fiber layer is being explored as a potential tool for rapid assessment in the clinic. The behavioral outcomes of PVD can mimic psychological conditions including autism spectrum disorder, attention deficit hyperactivity disorder, specific learning disability, and intellectual impairment, and one needs to be aware of overlap among these differential diagnoses. A practical functional approach providing working solutions for each child's set of difficulties in day-to-day activities is needed.
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Affiliation(s)
- Niranjan K Pehere
- Liberia Eye Center (L V Prasad Eye Institute Liberia Inc), John F Kennedy Memorial Medical Center, Monrovia, Liberia
| | - Gordon N Dutton
- Department of Vision Science, Glasgow Caledonian University, Glasgow, United Kingdom
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12
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Funayama M, Takata T, Nakagawa Y, Sunagawa K, Nakajima A, Kawashima H, Mimura M. Visuospatial working memory dysfunction from tapping span test as a diagnostic tool for patients with mild posterior cortical atrophy. Sci Rep 2021; 11:10580. [PMID: 34012020 PMCID: PMC8134425 DOI: 10.1038/s41598-021-90159-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/07/2021] [Indexed: 12/21/2022] Open
Abstract
Posterior cortical atrophy is a rare degenerative condition with prominent visuospatial dysfunction which commonly occurs between ages 50 and 65. A diagnosis of mild posterior cortical atrophy sometimes challenging and can be delayed because there are currently no established neuropsychological examination methods that can easily be used in clinical settings. In this study, we examined whether the tapping span test is a potential diagnostic tool for posterior cortical atrophy and what impairment the tapping span test is indicative of in this condition. Eight patients with mild posterior cortical atrophy were recruited. Age- and severity-matched individuals with amnesic Alzheimer's disease (n = 9) were also recruited as a control group. The participants were subjected to the tapping span test and several visuospatial working memory tests. The results of the tapping span and visuospatial working memory tests were worse for the posterior cortical atrophy group when compared with the control group. The results from the tapping span tests were strongly correlated with those from the visuospatial working memory tests. The tapping span test is a simple and potentially useful diagnostic tool for patients with mild posterior cortical atrophy, as it reflects visuospatial working memory function.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, Tochigi, 3260843, Japan. .,Department of Rehabilitation, Edogawa Hospital, Tokyo, 1330052, Japan.
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, Tochigi, 3260843, Japan
| | | | - Kosaku Sunagawa
- Faculty of Rehabilitation, Kansai Medical University, Osaka, 5820026, Japan
| | - Asuka Nakajima
- Department of Rehabilitation, Ashikaga Red Cross Hospital, Tochigi, 3260843, Japan
| | - Hiroaki Kawashima
- Department of Rehabilitation, Ashikaga Red Cross Hospital, Tochigi, 3260843, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, 1608582, Japan
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13
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Panico F, Arini A, Cantone P, Crisci C, Trojano L. Integrating visual search, eye movement training and reversing prism exposure in the treatment of Balint-Holmes syndrome: a single case report. Top Stroke Rehabil 2021; 29:280-285. [PMID: 33960916 DOI: 10.1080/10749357.2021.1923319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: For the first time, we administered reversing prism exposure to treat optic ataxia in a single patient with Balint-Holmes Syndrome (BHS), who also underwent specific trainings for simultanagnosia and ocular apraxia.Method and Results: By an introduction and withdrawal experimental design, we observed that the active treatment periods improved patient's visuospatial defects and functional autonomy.Conclusions: We thus provided a proof of principle supporting the use of reversing prism exposure in optic ataxia within an integrated and personalized rehabilitative approach for BHS.
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Affiliation(s)
- Francesco Panico
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Angela Arini
- Neurorehabilitation Unit, Clinic Center Rehabilitation Institute, Napoli, Italy
| | - Pierluigi Cantone
- Neurorehabilitation Unit, Clinic Center Rehabilitation Institute, Napoli, Italy
| | - Claudio Crisci
- Neurorehabilitation Unit, Clinic Center Rehabilitation Institute, Napoli, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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14
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Abstract
This chapter starts by reviewing the various interpretations of Bálint syndrome over time. We then develop a novel integrative view in which we propose that the various symptoms, historically reported and labeled by various authors, result from a core mislocalization deficit. This idea is in accordance with our previous proposal that the core deficit of Bálint syndrome is attentional (Pisella et al., 2009, 2013, 2017) since covert attention improves spatial resolution in visual periphery (Yeshurun and Carrasco, 1998); a deficit of covert attention would thus increase spatial uncertainty and thereby impair both visual object identification and visuomotor accuracy. In peripheral vision, we perceive the intrinsic characteristics of the perceptual elements surrounding us, but not their precise localization (Rosenholtz et al., 2012a,b), such that without covert attention we cannot organize them to their respective and recognizable objects; this explains why perceptual symptoms (simultanagnosia, neglect) could result from visual mislocalization. The visuomotor symptoms (optic ataxia) can be accounted for by both visual and proprioceptive mislocalizations in an oculocentric reference frame, leading to field and hand effects, respectively. This new pathophysiological account is presented along with a model of posterior parietal cortex organization in which the superior part is devoted to covert attention, while the right inferior part is involved in visual remapping. When the right inferior parietal cortex is damaged, additional representational mislocalizations across saccades worsen the clinical picture of peripheral mislocalizations due to an impairment of covert attention.
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15
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Kubota K, Kawai H, Takashima S, Shimohata T, Otsuki M, Ohnishi H, Shimozawa N. Clinical evaluation of childhood cerebral adrenoleukodystrophy with balint's symptoms. Brain Dev 2021; 43:396-401. [PMID: 33309491 DOI: 10.1016/j.braindev.2020.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/21/2020] [Accepted: 11/23/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Childhood cerebral adrenoleukodystrophy (CCALD) is the most common phenotype of adrenoleukodystrophy (ALD) and is characterized by the progression of intellectual, psychic, visual, and gait disturbances. Progression of this intractable disease can only be prevented by hematopoietic stem cell transplantation during the early stages of the disease. The aim of this study was to clinically evaluate children with CCALD who have visual symptoms to enable early diagnosis. METHODS We enrolled 41 Japanese children with CCALD who had visual symptoms. We retrospectively analyzed age of onset, past medical history, initial symptoms, visual symptoms and findings on brain magnetic resonance imaging. RESULTS The median age of disease onset was 7 years (range 5-10 years). The most common visual symptom was strabismus (n = 22). There was only one patient with the triad of symptoms of Balint's syndrome. Seventeen patients had incomplete Balint's syndrome and showed one or two of the triad of symptoms. Almost all patients with complete or incomplete Balint's syndrome showed bilateral parieto-occipital white matter lesions. CONCLUSIONS CCALD could develop into Balint's syndrome, especially the incomplete form. Therefore, CCALD should be considered when boys show new symptoms, including lack of eye contact or bumping into objects.
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Affiliation(s)
- Kazuo Kubota
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu, Japan; Division of Clinical Genetics, Gifu University Hospital, Gifu, Japan.
| | - Hiroki Kawai
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu, Japan; Division of Genomics Research, Life Science Research Center, Gifu University, Gifu, Japan
| | - Shigeo Takashima
- Division of Genomics Research, Life Science Research Center, Gifu University, Gifu, Japan
| | - Takayoshi Shimohata
- Department of Neurology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Mika Otsuki
- Faculty of Health Science, Hokkaido University, Sapporo, Japan
| | - Hidenori Ohnishi
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Nobuyuki Shimozawa
- Division of Clinical Genetics, Gifu University Hospital, Gifu, Japan; Division of Genomics Research, Life Science Research Center, Gifu University, Gifu, Japan
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16
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Dondi F, Albano D, Paghera B, Bertagna F, Giubbini R. 18F-FDG PET/CT in the Diagnosis and Follow-up of Balint Syndrome. Clin Nucl Med 2021; 46:e90-e93. [PMID: 33065619 DOI: 10.1097/rlu.0000000000003335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Balint syndrome is a rare neurological disorder characterized by simultanagnosia, optic ataxia, and ocular apraxia, and its etiology can be very heterogeneous. Diagnosis is based on neuropsychological evaluation, but brain radiological and nuclear medicine imaging also plays an important role. Because few case reports have been published in literature, in this work, we present 2 patients affected by Balint syndrome in which 18F-FDG PET/CT helped in the diagnosis and follow-up.
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Affiliation(s)
| | | | - Barbara Paghera
- Department of Nuclear Medicine, ASST Spedali Civili di Brescia, Brescia, Italy
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17
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Kesserwani H. The Zeitraffer Phenomenon: A Strategic Ischemic Infarct of the Banks of the Parieto-Occipital Sulcus - A Unique Case Report and a Side Note on the Neuroanatomy of Visual Perception. Cureus 2020; 12:e9443. [PMID: 32864267 PMCID: PMC7451087 DOI: 10.7759/cureus.9443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We describe the remarkable case of a medically healthy right-handed 15-year-old boy who developed an ischemic infarct of the banks of the right parieto-occipital sulcus (POs). The etiology of this infarct was undetermined, that is, cryptogenic. However, the focus of this article is functional neuroanatomy, as our patient developed a specific entity; an optic flow motion deficit characterized by slow self-motion of the left half of his body (egomotion) and slow motion of the surroundings (allocentric motion) together constituting the Zeitraffer phenomenon. We describe the neuroanatomy and neurophysiology of the dorsal visual stream and correlate the localization of this type of infarct in our patient with the known functional neuroanatomy. Although lesional studies in Macaque monkeys and functional MRI studies in humans have documented the clinical-functional correlations of POs lesions and perceived motion deficits, our case is one of the very first human cases in the literature that pinpoints the Zeitraffer phenomenon to a specific and strategic circumscribed ischemic stroke in the region of the POs.
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18
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Sunagawa K, Funayama M, Nakagawa Y, Tanemura R. Numeric input operation on electronic devices among individuals with visuospatial working memory impairment. Neuropsychol Rehabil 2020; 31:669-690. [PMID: 32031038 DOI: 10.1080/09602011.2020.1723650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ABSTRACTIn human-computer interactions, higher-level visuospatial function is likely needed to effectively use the interface. The aim of this study is to clarify whether individuals with visuospatial defects can use electronic devices effectively. We quantitatively and qualitatively analyzed the ability of seven individuals with Bálint syndrome and seven individuals with left-unilateral spatial neglect (USN) to input a digit sequence into a flat touch interface. Control groups consisted of seven individuals with memory deficits and 11 healthy individuals. Participants with Bálint syndrome took longer and had more hesitations than the USN group and the two control groups to input numerical sequences (Steel-Dwass test, p < .01). In addition, participants with Bálint syndrome had a high percentage of hesitations for exploration of the button array on the interface relative to USN and the memory deficit group (Fisher's exact test, p < .05). Regarding neuropsychological data, participants with Bálint syndrome had a lower score for visuospatial working memory than participants with USN and the memory deficits control group (Steel-Dwass test, p < .01). The results shed some light on the relation between visuospatial working memory deficits and the spatial perception of interface layouts and spatial control during electronic device operation.
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Affiliation(s)
- Kosaku Sunagawa
- Department of Rehabilitation, Faculty of Allied Health Sciences, Kansai University of Welfare Sciences, Osaka, Japan.,Department of Rehabilitation, Uegahara Hospital, Hyogo, Japan.,Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Hyogo, Japan
| | - Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan
| | | | - Rumi Tanemura
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Hyogo, Japan
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19
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Anobile G, Tomaiuolo F, Campana S, Cicchini GM. Three-systems for visual numerosity: A single case study. Neuropsychologia 2019; 136:107259. [PMID: 31726066 DOI: 10.1016/j.neuropsychologia.2019.107259] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/18/2019] [Accepted: 11/08/2019] [Indexed: 11/25/2022]
Abstract
Humans possess the remarkable capacity to assess the numerosity of a set of items over a wide range of conditions, from a handful of items to hundreds of them. Recent evidence is starting to show that judgments over such a large range is possible because of the presence of three mechanisms, each tailored to specific stimulation conditions. Previous evidence in favour of this theory comes from the fact that discrimination thresholds and estimation reaction times are not constants across numerosity levels. Likewise, attention is capable of dissociating the three mechanisms: when healthy adult observers are asked to perform concurrently a taxing task, the judgments of low numerosities (<4 dots) or of high numerosities is affected greatly, not so however for intermediate numerosities. Here we bring evidence from a neuropsychological perspective. To this end we measured perceptual performance in PA, a 41 year-old patient who suffers simultanagnosia after a hypoxic brain injury. PA showed a profound deficit in attentively tracking objects over space and time (multiple object tracking), even in very simple conditions where controls made no errors. PA also showed a massive deficit on sensory thresholds when comparing dot-arrays containing extremely low (3 dots) or extremely high (64, 128 dots) numerosities as well as in comparing dot-distances. Surprisingly, PA discrimination thresholds were relatively spared for intermediate numerosity (12 and 16 dots). Overall his deficit on the numerosity task results in a U-shape function across numerosity which, combined with the attentional deficit and the inability to judge dot-distances, confirms previously suggested three-systems for numerosity judgments.
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Affiliation(s)
- G Anobile
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - F Tomaiuolo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - S Campana
- Unità Gravi Cerebrolesioni Acquisite, Auxilium Vitae Volterra, Pisa, Italy
| | - G M Cicchini
- Institute of Neuroscience, National Research Council, Pisa, Italy.
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20
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Bowen M, Zutshi H, Cordiner M, Crutch S, Shakespeare T. Qualitative, exploratory pilot study to investigate how people living with posterior cortical atrophy, their carers and clinicians experience tests used to assess vision. BMJ Open 2019; 9:e020905. [PMID: 30898793 PMCID: PMC6475252 DOI: 10.1136/bmjopen-2017-020905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To investigate the experiences and views of people living with posterior cortical atrophy (PCA), their family carers and healthcare professionals of vision assessment tests. DESIGN A qualitative investigation using video recordings of vision assessments, semistructured interviews and audio recordings of a focus group. Interviews and focus group used broad, open questions around the topic to prompt and guide discussion. Video and audio recordings were transcribed, manually coded and analysed using framework analysis. SETTING University College, London's Queen Square neurology centre provided the venues for all stages of the research. PARTICIPANTS Participants living with PCA were one male and two females (age range 67-78 years). Health professional participants were a neurologist (male), two ophthalmologists (male) and an optometrist (female). PRIMARY AND SECONDARY OUTCOMES: (1) Experiences and attitudes of people living with PCA and health professionals to vision assessment tests, (2) views of health professionals and people living with PCA of whether some tests are more effective at discriminating between cortical vision problems and vision problems related to optical or ocular causes. RESULTS Patients were able to engage with and complete a number of tests. Their partners played a vital role in the process. Participants reported that simple, short tests were more effective than more subjective tests. Examples of tests that appeared to be more problematic for the patient participants were the Amsler Grid and visual field analysis. CONCLUSIONS Although limited in scope and execution, the project suggests that some vision assessment tests are likely to support health professionals to discriminate between cortical and optical/ocular causes of visual impairment. It supports existing evidence that there are vision assessments that people with dementia can engage with and complete. We identify areas of importance for future research and make tentative suggestions for clinical practice.
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Affiliation(s)
- Michael Bowen
- Department of Research, The College of Optometrists, London, UK
| | - Harry Zutshi
- Department of Research, The College of Optometrists, London, UK
| | - Martin Cordiner
- Department of Research, The College of Optometrists, London, UK
| | - Sebastian Crutch
- Dementia Research Centre, University College London, Institute of Neurology, London, UK
| | - Tim Shakespeare
- Dementia Research Centre, University College London, Institute of Neurology, London, UK
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21
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22
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Rossi KC, Brandstadter R, Fields MC, Leong J, Shin S. Clinical Reasoning: A 54-year-old woman with confusion and visual disturbances. Neurology 2018; 91:363-367. [DOI: 10.1212/wnl.0000000000006045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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23
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Bálint syndrome caused by bilateral medial occipital infarcts. Neurol Sci 2018; 39:1813-1814. [DOI: 10.1007/s10072-018-3490-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022]
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24
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Kowalczyk N, Shi F, Magnuski M, Skorko M, Dobrowolski P, Kossowski B, Marchewka A, Bielecki M, Kossut M, Brzezicka A. Real-time strategy video game experience and structural connectivity - A diffusion tensor imaging study. Hum Brain Mapp 2018; 39:3742-3758. [PMID: 29923660 DOI: 10.1002/hbm.24208] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 03/28/2018] [Accepted: 04/29/2018] [Indexed: 01/17/2023] Open
Abstract
Experienced video game players exhibit superior performance in visuospatial cognition when compared to non-players. However, very little is known about the relation between video game experience and structural brain plasticity. To address this issue, a direct comparison of the white matter brain structure in RTS (real time strategy) video game players (VGPs) and non-players (NVGPs) was performed. We hypothesized that RTS experience can enhance connectivity within and between occipital and parietal regions, as these regions are likely to be involved in the spatial and visual abilities that are trained while playing RTS games. The possible influence of long-term RTS game play experience on brain structural connections was investigated using diffusion tensor imaging (DTI) and a region of interest (ROI) approach in order to describe the experience-related plasticity of white matter. Our results revealed significantly more total white matter connections between occipital and parietal areas and within occipital areas in RTS players compared to NVGPs. Additionally, the RTS group had an altered topological organization of their structural network, expressed in local efficiency within the occipito-parietal subnetwork. Furthermore, the positive association between network metrics and time spent playing RTS games suggests a close relationship between extensive, long-term RTS game play and neuroplastic changes. These results indicate that long-term and extensive RTS game experience induces alterations along axons that link structures of the occipito-parietal loop involved in spatial and visual processing.
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Affiliation(s)
- Natalia Kowalczyk
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Feng Shi
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Mikolaj Magnuski
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Maciek Skorko
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | | | - Bartosz Kossowski
- Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Warsaw, Poland
| | - Artur Marchewka
- Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Warsaw, Poland
| | - Maksymilian Bielecki
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Malgorzata Kossut
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Laboratory of Neuroplasticity, Department of Molecular and Cellular Neurobiology, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Warsaw, Poland
| | - Aneta Brzezicka
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California
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25
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Jackson SR, Condon LA, Newport RW, Pears S, Husain M, Bajaj N, O'Donoghue M. Optic ataxia and the dorsal visual steam re-visited: Impairment in bimanual haptic matching performed without vision. Cortex 2018; 98:60-72. [DOI: 10.1016/j.cortex.2017.03.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/14/2017] [Accepted: 03/17/2017] [Indexed: 11/30/2022]
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26
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Sakurai Y, Fujimoto M, Hamada K, Sugimoto I. Asymmetric oculomotor apraxia, optic ataxia, and simultanagnosia with right hemispatial neglect from a predominantly left-sided lesion of the parieto-occipital area. Cogn Neuropsychiatry 2018; 23:1-14. [PMID: 29199507 DOI: 10.1080/13546805.2017.1407304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Bálint's syndrome involves bilateral damage to the parieto-occipital area. The extent of the effect of unilateral damage on the Bálint's triad (oculomotor apraxia, optic ataxia, and simultanagnosia) remains unknown. METHODS We examined a 63-year-old, right-handed woman who developed right hemianopia, oculomotor apraxia, optic ataxia, simultanagnosia, and hemispatial neglect (HSN) for the right after a cerebral infarction, with detailed neuropsychological tests, magnetic resonance imaging, and single photon emission computed tomography (SPECT). RESULTS Neuropsychological examination showed that oculomotor apraxia, optic ataxia, and simultanagnosia were more pronounced in the right hemi-space, probably due to the limited eye movement in the right visual field, whereas HSN was restricted to the right hemi-space. Diffusion-weighted MR images revealed hyperintensity in the left parieto-temporo-occipital region, and several spotty areas of the bilateral frontal and parietal subcortical regions. SPECT revealed hypoperfusion in the left parieto-occipital region and frontal operculum and small areas of the right superior parietal lobule. CONCLUSIONS The case suggests that asymmetric (more pronounced in the right hemi-space) oculomotor apraxia, optic ataxia, and simultanagnosia occur in an extensive lesion of the left parieto-occipital cortices. Although HSN is not a prerequisite for simultanagnosia, the coexistence of HSN aggravates simultanagnosia in the hemi-space opposite the lesion.
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Affiliation(s)
- Yasuhisa Sakurai
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan
| | - Masanori Fujimoto
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan.,b Department of Diabetes, Metabolism, and Endocrinology, Graduate School of Medicine , Chiba University , Chiba , Japan
| | - Kensuke Hamada
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan.,c Department of Neurology, Graduate School of Medicine , University of Tokyo , Tokyo , Japan
| | - Izumi Sugimoto
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan
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Abstract
This chapter reviews clinical and scientific approaches to optic ataxia. This double historic track allows us to address important issues such as the link between Bálint syndrome and optic ataxia, the alleged double dissociation between optic ataxia and visual agnosia, and the use of optic ataxia to argue for a specific vision-for-action occipitoposterior parietal stream. Clinical cases are described and reveal that perceptual deficits have been long shown to accompany ataxia. Importantly, the term ataxia appears to be misleading as patients exhibit a combination of visual and nonvisual perceptual, attentional, and visuomotor guidance deficits, which are confirmed by experimental approaches. Three major features of optic ataxia are described. The first is a spatial feature whereby the deficits exhibited by patients appear to be specific to peripheral vision, akin to the field effect. Visuomotor field examination allows us to quantify this deficit and reveals that it consists of a highly reliable retinocentric hypometria. The third is a temporal feature whereby these deficits are exacerbated under temporal constraints, i.e., when attending to dynamic stimuli. These two aspects combine in a situation where patients have to quickly respond to a target presented in peripheral vision that is experimentally displaced upon movement onset. In addition to the field effect, a hand effect can be described in conditions where the hand is not visible. Spatial and temporal aspects as well as field and hand effects may rely on several posterior parietal modules that remain to be precisely identified both anatomically and functionally. It is concluded that optic ataxia is not a visuomotor deficit and there is no dissociation between perception and action capacities in optic ataxia, hence a fortiori no double dissociation between optic ataxia and visual agnosia. Future directions for understanding the basic pathophysiology of optic ataxia are proposed.
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Affiliation(s)
- Yves Rossetti
- Integrative Multisensory Perception Action Cognition Team, Lyon Neuroscience Research Centre, Lyon, France.
| | - Laure Pisella
- Integrative Multisensory Perception Action Cognition Team, Lyon Neuroscience Research Centre, Lyon, France
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28
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The temporal dynamics involved in object representation updating to predict change. PROGRESS IN BRAIN RESEARCH 2017; 236:269-285. [PMID: 29157416 DOI: 10.1016/bs.pbr.2017.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
The synchronization of cortically disparate neural assemblies at frequencies in the gamma-band range (30-70Hz) is considered to be involved in the perceptual organization of the environment. In support of this Elliott (2014) demonstrated improved detection of a target stimulus when this target was primed in a matrix that flickered at specific frequencies in the gamma-band range, each found to be separated by regular intervals which correspond with a 6.69Hz period. This can be explained in terms of the interaction of the stimulus (and stimulus-induced) rhythm with a slow endogenous theta rhythm. When the interaction is in phase between these rhythms and target presentation time is slightly ahead of the priming stimulus presentation, improved detection times are recorded indicating an anticipatory response. However, when these rhythms are out of phase and the target is presented during or slightly after priming stimulus presentation, improved responding also occurs, suggesting a retroactive response is facilitated. Research in the auditory domain supports these findings (Aksentijevic et al., 2011). The conclusions of this research suggest that synchronization of neural assemblies contributes to the temporal code necessary to facilitate representation updating in order to respond to a dynamic environment and anticipate the logical next event.
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29
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Murphy RR, Al Sawaf A, Rose DR, Goldstein LB, Smith CD. Clinical Reasoning: Two see or not two see—Is it really double vision? Neurology 2017; 89:e56-e60. [DOI: 10.1212/wnl.0000000000004196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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30
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Simultaneous object perception deficits are related to reduced visual processing speed in amnestic mild cognitive impairment. Neurobiol Aging 2017; 55:132-142. [DOI: 10.1016/j.neurobiolaging.2017.03.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 03/24/2017] [Accepted: 03/25/2017] [Indexed: 12/11/2022]
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31
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Martinaud O. Visual agnosia and focal brain injury. Rev Neurol (Paris) 2017; 173:451-460. [DOI: 10.1016/j.neurol.2017.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 07/11/2017] [Accepted: 07/17/2017] [Indexed: 11/29/2022]
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32
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Abstract
Simultanagnosic patients have difficulty in perceiving multiple objects when presented simultaneously. In this review article, I discuss how neuropsychological research on simultanagnosia has been inspirational for two interconnected lines of research related to the core mechanisms by which the visual system processes cluttered scenes. First, I review previous studies on enumeration tasks indicating that, despite their inability to identify multiple objects, simultanagnosic patients can enumerate up to 2-3 elements as efficiently as healthy individuals (the so-called "subitizing" phenomenon). This intriguing observation is one of the first results to support the existence of an "object individuation" mechanism that can spatially tag a limited set of objects simultaneously, and resonates with recent research on the brain dynamics of enumeration in healthy individuals. Second, I further develop the implications of the dissociation between object identification and object enumeration in simultanagnosia specifically for the distinction between object identification and individuation. The latter distinction has been the subject of recent neuroimaging research that has provided fine-grained information on the spatial as well as temporal aspects of object individuation and recognition. The lessons learned from neuropsychological research on exact enumeration in simultanagnosia can be generalized to the normal functioning of the human mind, and have provided insightful clues for cognitive neuroscience.
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Affiliation(s)
- Veronica Mazza
- a Center for Mind/Brain Sciences (CIMeC) , University of Trento , Rovereto , TN , Italy
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33
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Chieffi S, Messina G, Messina A, Villano I, Monda V, Ambra FI, Garofalo E, Romano F, Mollica MP, Monda M, Iavarone A. Memory for Spatial Locations in a Patient with Near Space Neglect and Optic Ataxia: Involvement of the Occipitotemporal Stream. Front Neurol 2017; 8:231. [PMID: 28620345 PMCID: PMC5449448 DOI: 10.3389/fneur.2017.00231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 05/12/2017] [Indexed: 11/13/2022] Open
Abstract
Previous studies suggested that the occipitoparietal stream orients attention toward the near/lower space and is involved in immediate reaching, whereas the occipitotemporal stream orients attention toward the far/upper space and is involved in delayed reaching. In the present study, we investigated the role of the occipitotemporal stream in attention orienting and delayed reaching in a patient (GP) with bilateral damage to the occipitoparietal areas and optic ataxia. GP and healthy controls took part in three experiments. In the experiment 1, the participants bisected lines oriented along radial, vertical, and horizontal axes. GP bisected radial lines farther, and vertical lines more above, than the controls, consistent with an attentional bias toward the far/upper space and near/lower space neglect. The experiment 2 consisted of two tasks: (1) an immediate reaching task, in which GP reached target locations under visual control and (2) a delayed visual reaching task, in which GP and controls were asked to reach remembered target locations visually presented. We measured constant and variable distance and direction errors. In immediate reaching task, GP accurately reached target locations. In delayed reaching task, GP overshot remembered target locations, whereas the controls undershot them. Furthermore, variable errors were greater in GP than in the controls. In the experiment 3, GP and controls performed a delayed proprioceptive reaching task. Constant reaching errors did not differ between GP and the controls. However, variable direction errors were greater in GP than in the controls. We suggest that the occipitoparietal damage, and the relatively intact occipitotemporal region, produced in GP an attentional orienting bias toward the far/upper space (experiment 1). In turns, the attentional bias selectively shifted toward the far space remembered visual (experiment 2), but not proprioceptive (experiment 3), target locations. As a whole, these findings further support the hypothesis of an involvement of the occipitotemporal stream in delayed reaching. Furthermore, the observation that in both delayed reaching tasks the variable errors were greater in GP than in the controls suggested that in optic ataxia is present not only a visuo- but also a proprioceptivo-motor integration deficit.
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Affiliation(s)
- Sergio Chieffi
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giovanni Messina
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.,Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonietta Messina
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ines Villano
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Vincenzo Monda
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ferdinando Ivano Ambra
- Neurological and Stroke Unit, CTO Hospital, AORN "Ospedali dei Colli" Naples, Naples, Italy
| | - Elisabetta Garofalo
- Neurological and Stroke Unit, CTO Hospital, AORN "Ospedali dei Colli" Naples, Naples, Italy
| | - Felice Romano
- Neurological and Stroke Unit, CTO Hospital, AORN "Ospedali dei Colli" Naples, Naples, Italy
| | - Maria Pina Mollica
- Department of Biology, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Marcellino Monda
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Iavarone
- Neurological and Stroke Unit, CTO Hospital, AORN "Ospedali dei Colli" Naples, Naples, Italy
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D’Imperio D, Scandola M, Gobbetto V, Bulgarelli C, Salgarello M, Avesani R, Moro V. Visual and cross-modal cues increase the identification of overlapping visual stimuli in Balint’s syndrome. J Clin Exp Neuropsychol 2017; 39:786-802. [DOI: 10.1080/13803395.2016.1266307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Daniela D’Imperio
- Department of Psychology, AgliotiLab, University of Rome, Faculty of Medicine and Psychology, Rome, Italy
- Department of Human Sciences, Npsy.Lab-Vr, University of Verona, Verona, Italy
| | - Michele Scandola
- Department of Human Sciences, Npsy.Lab-Vr, University of Verona, Verona, Italy
- Department of Rehabilitation, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Valeria Gobbetto
- Department of Rehabilitation, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Cristina Bulgarelli
- Department of Rehabilitation, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Matteo Salgarello
- Nuclear Medicine Unit, Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | - Renato Avesani
- Department of Rehabilitation, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Valentina Moro
- Department of Human Sciences, Npsy.Lab-Vr, University of Verona, Verona, Italy
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35
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Chokron S, Dutton GN. Impact of Cerebral Visual Impairments on Motor Skills: Implications for Developmental Coordination Disorders. Front Psychol 2016; 7:1471. [PMID: 27757087 PMCID: PMC5048540 DOI: 10.3389/fpsyg.2016.01471] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 09/13/2016] [Indexed: 12/16/2022] Open
Abstract
Cerebral visual impairment (CVI) has become the primary cause of visual impairment and blindness in children in industrialized countries. Its prevalence has increased sharply, due to increased survival rates of children who sustain severe neurological conditions during the perinatal period. Improved diagnosis has probably contributed to this increase. As in adults, the nature and severity of CVI in children relate to the cause, location and extent of damage to the brain. In the present paper, we define CVI and how this impacts on visual function. We then define developmental coordination disorder (DCD) and discuss the link between CVI and DCD. The neuroanatomical correlates and aetiologies of DCD are also presented in relationship with CVI as well as the consequences of perinatal asphyxia (PA) and preterm birth on the occurrence and nature of DCD and CVI. This paper underlines why there are both clinical and theoretical reasons to disentangle CVI and DCD, and to categorize the features with more precision. In order to offer the most appropriate rehabilitation, we propose a systematic and rapid evaluation of visual function in at-risk children who have survived preterm birth or PA whether or not they have been diagnosed with cerebral palsy or DCD.
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Affiliation(s)
- Sylvie Chokron
- Unité Fonctionnelle Vision and Cognition, Fondation Ophtalmologique RothschildParis, France; Laboratoire de Psychologie de la Perception, UMR 8242, Centre National de la Recherche Scientifique - Université Paris-DescartesParis, France
| | - Gordon N Dutton
- Department of Vision Science, Glasgow Caledonian University Glasgow, UK
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36
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Neitzel J, Ortner M, Haupt M, Redel P, Grimmer T, Yakushev I, Drzezga A, Bublak P, Preul C, Sorg C, Finke K. Neuro-cognitive mechanisms of simultanagnosia in patients with posterior cortical atrophy. Brain 2016; 139:3267-3280. [DOI: 10.1093/brain/aww235] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/01/2016] [Accepted: 07/31/2016] [Indexed: 11/13/2022] Open
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Rose A, Wilson BA, Manolov R, Florschutz G. Seeing red: Relearning to read in a case of Balint’s Syndrome. NeuroRehabilitation 2016; 39:111-7. [DOI: 10.3233/nre-161342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Anita Rose
- Department of Neuropsychology, Raphael Medical Centre, Tonbridge, Kent, UK
| | - Barbara A. Wilson
- The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Ely, UK
| | - Rumen Manolov
- Department of Behavioural Sciences Methods, University of Barcelona, Barcelona, Spain
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38
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Moscote-Salazar LR, Calderon-Miranda WG, Carmona-Meza ZA, Alvis-Miranda HR, Churio NZ, Alcalá-Cerra G, M. Rubiano A. Post-Traumatic Balint's Syndrome: A Case Report and Review of the Literature. Bull Emerg Trauma 2016; 4:113-115. [PMID: 27331070 PMCID: PMC4897994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 02/02/2016] [Accepted: 02/22/2016] [Indexed: 06/06/2023] Open
Abstract
Balint’s syndrome is a rare neurological disorder associated with bilateral parieto-occipital damage which was described by Rezsö Bálint in 1909.The syndrome is manifested clinically by the presence of a hemispatial negligence. The lesion is usually inside parietooccipital region bilaterally in most cases but may also be compromised angular convolutions, the dorsolateral area of the occipital lobe as the superior parietal lobule. We herein report a 61-year-old man with traumatic brain injury who was diagnosed to have right parieto-occipital contusion in radiologic evaluation. Physical examination was consistent with Balint's syndrome. The patient was followed for 12 months post-injury and received 4-months of outpatient rehabilitation. Patient showed improvement of Balint’s syndrome 8 months after the starts of symptoms.
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Affiliation(s)
- Luis Rafael Moscote-Salazar
- Neurosurgeon-Critical Care, RED LATINO, Latin American Trauma & Intensive Neuro-Care Organization, Bogotá, Colombia
| | | | | | | | | | | | - Andrés M. Rubiano
- Department of Neurosurgery, Universidad El Bosque, RED LATINO, Latin American Trauma & Intensive Neuro-Care Organization, Bogotá, Colombia
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39
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Álvarez R, Masjuan J. Agnosias visuales. Rev Clin Esp 2016; 216:85-91. [DOI: 10.1016/j.rce.2015.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 07/14/2015] [Accepted: 07/16/2015] [Indexed: 10/23/2022]
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40
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Álvarez R, Masjuan J. Visual agnosia. Rev Clin Esp 2016. [DOI: 10.1016/j.rceng.2015.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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Cooper SA, O'Sullivan M. Here, there and everywhere: higher visual function and the dorsal visual stream. Pract Neurol 2016; 16:176-83. [PMID: 26786007 DOI: 10.1136/practneurol-2015-001168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 01/12/2023]
Abstract
The dorsal visual stream, often referred to as the 'where' stream, represents the pathway taken by visual information from the primary visual cortex to the posterior parietal lobe and onwards. It partners the ventral or 'what' stream, the subject of a previous review and largely a temporal-based system. Here, we consider the dorsal stream disorders of perception (simultanagnosia, akinetopsia) along with their consequences on action (eg, optic ataxia and oculomotor apraxia, along with Balint's syndrome). The role of the dorsal stream in blindsight and hemispatial neglect is also considered.
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Affiliation(s)
- Sarah Anne Cooper
- Department of Neurology, Hurstwood Park Neurological Centre, Princess Royal Hospital, Haywards Heath, UK
| | - Michael O'Sullivan
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
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42
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Functional connectivity indicates differential roles for the intraparietal sulcus and the superior parietal lobule in multiple object tracking. Neuroimage 2015; 123:129-37. [PMID: 26299796 DOI: 10.1016/j.neuroimage.2015.08.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 07/21/2015] [Accepted: 08/13/2015] [Indexed: 11/20/2022] Open
Abstract
Attentive tracking requires sustained object-based attention, rather than passive vigilance or rapid attentional shifts to brief events. Several theories of tracking suggest a mechanism of indexing objects that allows for attentional resources to be directed toward the moving targets. Imaging studies have shown that cortical areas belonging to the dorsal frontoparietal attention network increase BOLD-signal during multiple object tracking (MOT). Among these areas, some studies have assigned IPS a particular role in object indexing, but the neuroimaging evidence has been sparse. In the present study, we tested participants on a continuous version of the MOT task in order to investigate how cortical areas engage in functional networks during attentional tracking. Specifically, we analyzed the data using eigenvector centrality mapping (ECM) analysis, which provides estimates of individual voxels' connectedness with hub-like parts of the functional network. The results obtained using permutation based voxel-wise statistics support the proposed role for the IPS in object indexing as this region displayed increased centrality during tracking as well as increased functional connectivity with both prefrontal and visual perceptual cortices. In contrast, the opposite pattern was observed for the SPL, with decreasing centrality, as well as reduced functional connectivity with the visual and frontal cortices, in agreement with a hypothesized role for SPL in attentional shifts. These findings provide novel evidence that IPS and SPL serve different functional roles during MOT, while at the same time being highly engaged during tracking as measured by BOLD-signal changes.
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43
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Funayama M, Nakagawa Y, Sunagawa K. Visuospatial working memory is severely impaired in Bálint syndrome patients. Cortex 2015; 69:255-64. [PMID: 26117797 DOI: 10.1016/j.cortex.2015.05.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 05/10/2015] [Accepted: 05/22/2015] [Indexed: 10/23/2022]
Abstract
Although it has been proposed that visuospatial working memory may be impaired in Bálint syndrome patients, neither a systematic study concerning this proposal nor a comparison with patients having right-parietal damage has been made. Visuospatial working memory was assessed for six Bálint syndrome patients and members of two control groups-one composed of individuals with right-parietal damage (n = 15) and a second of age- and gender-matched healthy individuals (n = 26). We placed special emphasis on patients with a mild form of Bálint syndrome who can judge positional relationships between two objects. First, the participants were subjected to delayed visuospatial matching tasks. Next, their visuospatial-temporal integration abilities were assessed using a shape-from-moving-dots task. Visuospatial working memory was impaired for Bálint syndrome patients compared with controls according to the results of the tests. The differences between the Bálint syndrome and control subjects remained when only data for patients with the mild form of Bálint syndrome were included. We conclude that visuospatial working memory may be severely impaired in Bálint syndrome patients and, therefore, might influence their inability to properly execute movements and behaviours associated with daily living.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan.
| | | | - Kosaku Sunagawa
- Department of Rehabilitation, Edogawa Hospital, Tokyo, Japan; Department of Rehabilitation, Uegahara Hospital, Hyogo, Japan; Kobe University Graduate School of Health Sciences, Hyogo, Japan
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44
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Khan AZ, Prost-Lefebvre M, Salemme R, Blohm G, Rossetti Y, Tilikete C, Pisella L. The Attentional Fields of Visual Search in Simultanagnosia and Healthy Individuals: How Object and Space Attention Interact. Cereb Cortex 2015; 26:1242-54. [PMID: 25840422 DOI: 10.1093/cercor/bhv059] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Simultanagnosia is a deficit in which patients are unable to perceive multiple objects simultaneously. To date, it remains disputed whether this deficit results from disrupted object or space perception. We asked both healthy participants as well as a patient with simultanagnosia to perform different visual search tasks of variable difficulty. We also modulated the number of objects (target and distracters) presented. For healthy participants, we found that each visual search task was performed with a specific "attentional field" depending on the difficulty of visual object processing but not on the number of objects falling within this "working space." This was demonstrated by measuring the cost in reaction times using different gaze-contingent visible window sizes. We found that bilateral damage to the superior parietal lobule impairs the spatial integration of separable features (within-object processing), shrinking the attentional field in which a target can be detected, but causing no deficit in processing multiple objects per se.
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Affiliation(s)
- A Z Khan
- ImpAct - Lyon Neuroscience Research Center, Inserm U1028, CNRS UMR 5292, Bron, France Université de Lyon, Biologie Humaine, Bron, France Hospices Civils de Lyon, Bron, France School of Optometry, University of Montreal, Montreal, QC, Canada
| | - M Prost-Lefebvre
- ImpAct - Lyon Neuroscience Research Center, Inserm U1028, CNRS UMR 5292, Bron, France Université de Lyon, Biologie Humaine, Bron, France Hospices Civils de Lyon, Bron, France
| | - R Salemme
- ImpAct - Lyon Neuroscience Research Center, Inserm U1028, CNRS UMR 5292, Bron, France Université de Lyon, Biologie Humaine, Bron, France Hospices Civils de Lyon, Bron, France
| | - G Blohm
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Y Rossetti
- ImpAct - Lyon Neuroscience Research Center, Inserm U1028, CNRS UMR 5292, Bron, France Université de Lyon, Biologie Humaine, Bron, France Hospices Civils de Lyon, Bron, France
| | - C Tilikete
- ImpAct - Lyon Neuroscience Research Center, Inserm U1028, CNRS UMR 5292, Bron, France Université de Lyon, Biologie Humaine, Bron, France Hospices Civils de Lyon, Bron, France
| | - L Pisella
- ImpAct - Lyon Neuroscience Research Center, Inserm U1028, CNRS UMR 5292, Bron, France Université de Lyon, Biologie Humaine, Bron, France Hospices Civils de Lyon, Bron, France
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45
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Sunagawa K, Nakagawa Y, Funayama M. Effectiveness of Use of Button-Operated Electronic Devices Among Persons With Bálint Syndrome. Am J Occup Ther 2015; 69:6902290050. [DOI: 10.5014/ajot.2015.014522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. Little is known about how visuospatial deficits affect the use of electronic devices operated by pressing spatially interspersed buttons. This study aimed to determine whether people with Bálint syndrome can effectively use such devices.
METHOD. We quantified the ability of 7 study participants with Bálint syndrome to use button-operated electronic devices by measuring the time required to input digit sequences into three different types of devices. Control groups were 8 participants with amnesia and 8 healthy participants.
RESULTS. Participants with Bálint syndrome took longer to input a digit sequence on all three devices than did those in the two control groups. Although we found no significant differences with respect to type of device, 2 of 3 participants with severe Bálint syndrome were able to input one- to five-digit sequences with the electronic calculator.
CONCLUSION. Distinctive design features might positively affect the performance of people with Bálint syndrome.
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Affiliation(s)
- Kosaku Sunagawa
- Kosaku Sunagawa, MSc, OTR, is Occupational Therapy Practitioner, Department of Occupational Therapy, Edogawa Hospital, Tokyo, Japan;
| | - Yoshitaka Nakagawa
- Yoshitaka Nakagawa, MSc, RST, is Chief, Department of Speech Therapy, Edogawa Hospital, Tokyo, Japan;
| | - Michitaka Funayama
- Michitaka Funayama, MD, is Chief, Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan;
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46
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Beh SC, Muthusamy B, Calabresi P, Hart J, Zee D, Patel V, Frohman E. Hiding in plain sight: a closer look at posterior cortical atrophy. Pract Neurol 2014; 15:5-13. [DOI: 10.1136/practneurol-2014-000883] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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47
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Abstract
Visual failure of any kind is a common clinical presentation and indication for neuroimaging. Monocular deficits should concentrate the search to the anterior (prechiasmatic) visual pathway. Bitemporal hemianopia suggests a chiasmatic cause, whereas retrochiasmatic lesions characteristically cause homonymous hemianopic defects. Quadrantanopias usually arise from lesions in the optic radiations. Disorders of visual perception can be broadly divided into "where" and "what" problems caused by lesions in the parietal and temporal lobes, respectively, and their associated white matter tracts. Visualization of the retrochiasmatic visual and visual association pathways is aided by diffusion tensor imaging.
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Affiliation(s)
| | - Adam G Thomas
- Imaging Department, Leicester Royal Infirmary, Leicester, UK; Department of Neuroradiology, Queens Medical Centre, Nottingham, UK.
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48
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Amalnath SD, Kumar S, Deepanjali S, Dutta TK. Balint syndrome. Ann Indian Acad Neurol 2014; 17:10-1. [PMID: 24753652 PMCID: PMC3992743 DOI: 10.4103/0972-2327.128526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 09/20/2013] [Accepted: 10/02/2013] [Indexed: 11/04/2022] Open
Abstract
We report a patient who presented with complaints of blindness following stroke and was subsequently diagnosed to have Balint syndrome.
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Affiliation(s)
- S Deepak Amalnath
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sai Kumar
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - S Deepanjali
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Tarun Kumar Dutta
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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49
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Chechlacz M, Humphreys GW. The enigma of Bálint's syndrome: neural substrates and cognitive deficits. Front Hum Neurosci 2014; 8:123. [PMID: 24639641 PMCID: PMC3945799 DOI: 10.3389/fnhum.2014.00123] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 02/19/2014] [Indexed: 01/06/2023] Open
Affiliation(s)
| | - Glyn W Humphreys
- Department of Experimental Psychology, University of Oxford Oxford, UK
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50
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Mevorach C, Shalev L, Green RJ, Chechlacz M, Riddoch MJ, Humphreys GW. Hierarchical processing in Balint's syndrome: a failure of flexible top-down attention. Front Hum Neurosci 2014; 8:113. [PMID: 24578689 PMCID: PMC3936250 DOI: 10.3389/fnhum.2014.00113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 02/13/2014] [Indexed: 11/19/2022] Open
Abstract
Patients with Balint’ s syndrome are typically impaired at perceiving multiple objects simultaneously, and at evaluating the relationship between multiple objects in a scene (simultanagnosia). These deficits may not only be observed in complex scenes, but also when local elements of individual objects must be integrated into a perceptual global whole. Thus, unlike normal observers, patients with simultanagnosia typically show a bias towards the local forms, even to the extent that they cannot identify the global stimuli. However, we have previously shown that global processing is still attainable in Balint patients in certain scenarios (e.g., when local elements are unfamiliar). This suggests that in addition to a possible perceptual deficit that favors the local elements in these patients, impaired attentional control may be at the core of their unique performance. To test this hypothesis we manipulated the perceptual saliency of the local and global elements in a compound letter task so that it included global-more-salient or local-more-salient displays. We show that a Balint patient was able to accurately identify both global and local targets as long as they were the salient aspect of the compound letter. However, substantial impairment was evident when either the global or local elements were the less salient aspect of the compound letter. We conclude that in Balint’ s syndrome there is a failure of flexible top-down attention both in biasing attention away from salient irrelevant aspects of the display (salience-based-selection) and in impaired disengagement from irrelevant but salient items once they have been selected.
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Affiliation(s)
- Carmel Mevorach
- Behavioural Brain Sciences Centre, School of Psychology, University of Birmingham Birmingham, UK
| | - Lilach Shalev
- The Constantiner School of Education, Tel-Aviv University Tel Aviv, Israel ; Sagol School of Neuroscience, Tel-Aviv University Tel Aviv, Israel
| | - Robin J Green
- Behavioural Brain Sciences Centre, School of Psychology, University of Birmingham Birmingham, UK
| | - Magda Chechlacz
- Department of Experimental Psychology, University of Oxford Oxford, UK
| | - M Jane Riddoch
- Department of Experimental Psychology, University of Oxford Oxford, UK
| | - Glyn W Humphreys
- Department of Experimental Psychology, University of Oxford Oxford, UK
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