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Coll SY, Marti E, Doganci N, Ptak R. The disengagement deficit after right-hemisphere damage: Distinct roles of lateral frontal and parietal damage. Brain Res Bull 2024; 214:111003. [PMID: 38852652 DOI: 10.1016/j.brainresbull.2024.111003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/21/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
An influential model of spatial attention postulates three main attention-orienting mechanisms: disengagement, shifting, and engagement. Early research linked disengagement deficits with superior parietal damage, regardless of hemisphere or presence of spatial neglect. Subsequent studies supported the involvement of more ventral parietal regions, especially in the right hemisphere, and linked spatial neglect to deficient disengagement from ipsilateral cues. However, previous lesion studies faced serious limitations, such as small sample sizes and the lack of brain-injured controls without neglect. Additionally, some studies employed symbolic cues or used long cue-target intervals, which may fail to reveal impaired disengagement. We here used a machine-learning approach to conduct lesion-symptom mapping (LSM) on 89 patients with focal cerebral lesions to the left (LH) or right (RH) cerebral hemisphere. A group of 54 healthy participants served as controls. The paradigm used to uncover disengagement deficits employed non-predictive cues presented in the visual periphery and at short cue-target intervals, targeting exogenous attention. The main factors of interest were group (healthy participants, LH, RH), target position (left, right hemifield) and cue validity (valid, invalid). LSM-analyses were performed on two indices: the validity effect, computed as the absolute difference between reaction times (RTs) following invalid compared to valid cues, and the disengagement deficit, determined by the difference between contralesional and ipsilesional validity effects. While LH patients showed general slowing of RTs to contralesional targets, only RH patients exhibited a disengagement deficit from ipsilesional cues. LSM associated the validity effect with a right lateral frontal cluster, which additionally affected subcortical white matter of the right arcuate fasciculus, the corticothalamic pathway, and the superior longitudinal fasciculus. In contrast, the disengagement deficit was related to damage involving the right temporoparietal junction. Thus, our results support the crucial role of right inferior parietal and posterior temporal regions for attentional disengagement, but also emphasize the importance of lateral frontal regions, for the reorienting of attention.
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Affiliation(s)
- Sélim Yahia Coll
- Laboratory of Cognitive Neurorehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
| | - Emilie Marti
- Laboratory of Cognitive Neurorehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Naz Doganci
- Laboratory of Cognitive Neurorehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Radek Ptak
- Laboratory of Cognitive Neurorehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
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Arya KN, Pandian S, Pandey D, Agarwal GG, Chaudhary N. Task-based and Magnified Mirror Therapy for Unilateral Spatial Neglect among post-stroke subjects: Study protocol for a randomized controlled trial. PLoS One 2024; 19:e0296276. [PMID: 38265989 PMCID: PMC10807845 DOI: 10.1371/journal.pone.0296276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 12/01/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Unilateral spatial neglect (USN) is a commonly occurring neurocognitive disability after a stroke. The neglect may affect the motor recovery of the upper and lower limbs and functional performances. Mirror therapy, a simple and economical approach has the potential to reduce the USN and related impairments. AIM The primary objective of this study is to determine the effectiveness of task-based and magnified mirror therapy on the USN and on the motor recovery of the post-stroke subjects. The secondary objective is to investigate the effectiveness of the intervention on the function and disability of the subjects. METHODS In this randomized controlled, assessor-blinded trial, 86 post-stroke subjects will be recruited from the neuro-rehabilitation laboratory of a rehabilitation institute, located in northern India. The participants,aged20 to 80 years, with 1 to 36 months of stroke onset, hemiparesis, and the USN, will be considered eligible for the study. In addition to the conventional rehabilitation, the experimental group(n = 43) will receive 40 sessions (8 weeks) of Task-based and MAGnified Mirror Therapy for Unilateral Spatial Neglect (T-MAGUSN). The control group (n = 43) will undergo a dose-matched conventional program only. The participants will be assessed at baseline, post-intervention and 4-week follow-up using primary (Line Bisection Test, Letter Cancellation Test, and Fugl-Myer Assessment) and secondary (Catherine Bergego Scale, Berg Balance Scale, Functional Ambulation Classification, Modified Rankin Scale) outcome measures. DISCUSSION This proposed study will lead to the development of a novel rehabilitation protocol for the management of USN, aiming to enhance motor and functional recovery. The investigation will consider both the upper and lower limbs for the intervention, reducing the impact of cognitive disability in stroke. TRIAL REGISTRATION Clinical Trial Registry of India (CTRI) as CTRI/2023/05/053184 (www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=74659).
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Affiliation(s)
- Kamal Narayan Arya
- Department of Occupational Therapy, Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India
| | - Shanta Pandian
- Department of Occupational Therapy, Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India
| | - Divya Pandey
- Department of Occupational Therapy, Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India
| | - G. G. Agarwal
- Department of Statistics, Lucknow University, Lucknow, Uttar Pradesh, India
| | - Neera Chaudhary
- Department of Neurology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
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Wardrope A. The promises and pitfalls of seizure phenomenology. Seizure 2023; 113:48-53. [PMID: 37976801 DOI: 10.1016/j.seizure.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023] Open
Abstract
The typical adult patient presenting with a first seizure has a normal clinical examination, uninformative investigations, and often has no witness to their episode. The assessing clinician, therefore, has one primary source of information to guide their assessment; the patient's experience. However, seizure phenomenology - the subjective seizure experience - has received relatively less attention by researchers than objective semiology or investigations. This essay reviews the clinical importance of seizure phenomenology, and the challenges clinicians face in eliciting accurate and clinically relevant descriptions of ictal experience. I conclude by discussing tools that clinicians may use to support the clinical application of seizure phenomenology, and exploring the subjectivity of epilepsy more broadly.
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Affiliation(s)
- Alistair Wardrope
- Academic Neurology Unit, The University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, United Kingdom; Department of Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, United Kingdom.
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Casalvera A, Goodwin M, Lynch K, Teferi M, Patel M, Grillon C, Ernst M, Balderston NL. Threat of shock increases distractor susceptibility during the short-term maintenance of visual information. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.22.23298914. [PMID: 38045307 PMCID: PMC10690351 DOI: 10.1101/2023.11.22.23298914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
BACKGROUND Work on anxiety related attention control deficits suggests that elevated arousal impacts the ability to filter out distractors. To test this, we designed a task to look at distractor suppression during periods of threat. We administered trials of a visual short-term memory (VSTM) task, during periods of unpredictable threat, and hypothesized that threat would impair performance during trials where subjects were required to filter out large numbers of distractors. METHOD Experiment 1 involved fifteen healthy participants who completed one study visit. They performed four runs of a VSTM task comprising 32 trials each. Participants were presented with an arrow indicating left or right, followed by an array of squares. They were instructed to remember the target side and disregard the distractors on the off-target side. A subsequent target square was shown, and participants indicated whether it matched one of the previously presented target squares. The trial conditions included 50% matches and 50% mismatches, with an equal distribution of left and right targets. The number of target and distractor squares varied systematically, with high (4 squares) and low (2 squares) target and distractor conditions. Trials alternated between periods of safety and threat, with startle responses recorded using electromyography (EMG) following white noise presentations. Experiment 2 involved twenty-seven healthy participants who completed the same VSTM task inside an MRI scanner during a single study visit. The procedure mirrored that of Experiment 1, except for the absence of white noise presentations. RESULTS For Experiment 1, subjects showed significantly larger startle responses during threat compared to safe period, supporting the validity of the threat manipulation. However, results suggested that the white noise probes interfered with performance. For Experiment 2, we found that both accuracy was affected by threat, such that distractor load negatively impacted accuracy only in the threat condition. CONCLUSION Overall, these findings suggest that threat affects distractor susceptibility during the short-term maintenance of visual information. The presence of threat makes it more difficult to filter out distracting information. We believe that this is related to hyperarousal of parietal cortex, which has been observed during unpredictable threat.
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Affiliation(s)
- Abigail Casalvera
- Center for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Madeline Goodwin
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Kevin Lynch
- Center for Clinical Epidemiology and Biostatistics, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Marta Teferi
- Center for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Milan Patel
- Center for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Christian Grillon
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Monique Ernst
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Nicholas L Balderston
- Center for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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Steigerwald AJ, Ferguson BJ, Nuraini N, Barnett JC, Takahashi N, Zamzow R, Heilman KM, Beversdorf DQ. Altered Allocation of Vertical Attention in Individuals With Autism Spectrum Disorder. Cogn Behav Neurol 2023; 36:159-165. [PMID: 37067989 DOI: 10.1097/wnn.0000000000000342] [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: 06/06/2022] [Accepted: 02/03/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND Typical adults most frequently orient their attention to other people's eyes, whereas individuals with autism spectrum disorder (ASD) orient their attention to other people's mouths. Typical adults also reveal visuospatial biases on tasks such as vertical and horizontal line bisections. Therefore, the difference in face viewing might be related to a more general group difference in the allocation of vertical attention. OBJECTIVE To use vertical line bisection and quadrisection tasks to evaluate whether individuals with ASD have a more downward-oriented vertical attentional bias than do typical individuals. METHOD We recruited 20 individuals with ASD and 20 control participants matched for age (6-23 years), IQ, and sex. We asked the individuals to bisect and quadrisect lines on the top and bottom when the vertical lines were placed at the intersection of their right, left, and center egocentric sagittal planes and their coronal plane. The distances from the true midpoint and quadripoint were measured, and between-group performances were compared. RESULTS No significant difference was found between the ASD and control groups for vertical line bisections or lower line quadrisections. However, when the ASD group was compared with the control group for higher line quadrisections, the ASD group exhibited a greater upward deviation. CONCLUSION There is no downward vertical attentional spatial bias associated with ASD that could help to explain these individuals' attentional bias toward the mouth. However, additional studies are required to learn if this atypical upward vertical attentional bias might account for some of the symptoms and signs associated with ASD.
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Affiliation(s)
| | - Bradley J Ferguson
- Thompson Center for Autism and Neurodevelopmental Disorders, Columbia, Missouri
- Departments of Health Psychology and Radiology, University of Missouri-Columbia, Columbia, Missouri
| | - Nanan Nuraini
- Interdisciplinary Neuroscience Program, University of Missouri-Columbia, Columbia, Missouri
| | | | - Nicole Takahashi
- Thompson Center for Autism and Neurodevelopmental Disorders, Columbia, Missouri
| | - Rachel Zamzow
- Interdisciplinary Neuroscience Program, University of Missouri-Columbia, Columbia, Missouri
| | - Kenneth M Heilman
- Department of Neurology, University of Florida, and NF/SG Veterans Affairs Medical Center, Gainesville, Florida
| | - David Q Beversdorf
- Thompson Center for Autism and Neurodevelopmental Disorders, Columbia, Missouri
- Interdisciplinary Neuroscience Program, University of Missouri-Columbia, Columbia, Missouri
- Departments of Radiology, Neurology, and Psychological Sciences, William and Nancy Thompson Endowed Chair in Radiology, University of Missouri-Columbia, Columbia, Missouri
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Leitner MC, Ladek AM, Hutzler F, Reitsamer H, Hawelka S. Placebo effect after visual restitution training: no eye-tracking controlled perimetric improvement after visual border stimulation in late subacute and chronic visual field defects after stroke. Front Neurol 2023; 14:1114718. [PMID: 37456634 PMCID: PMC10339290 DOI: 10.3389/fneur.2023.1114718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction A significant number of Restitution Training (RT) paradigms claim to ameliorate visual field loss after stroke by re-activating neuronal connections in the residual visual cortex due to repeated bright light-stimulation at the border of the blind and intact fields. However, the effectiveness of RT has been considered controversial both in science and clinical practice for years. The main points of the controversy are (1) the reliability of perimetric results which may be affected by compensatory eye movements and (2) heterogeneous samples consisting of patients with visual field defects and/or visuospatial neglect. Methods By means of our newly developed and validated Virtual Reality goggles Salzburg Visual Field Trainer (SVFT) 16 stroke patients performed RT on a regular basis for 5 months. By means of our newly developed and validated Eye Tracking Based Visual Field Analysis (EFA), we conducted a first-time full eye-movement-controlled perimetric pre-post intervention study. Additionally, patients subjectively rated the size of their intact visual field. Results Analysis showed that patients' mean self-assessment of their subjective visual field size indicated statistically significant improvement while, in contrast, objective eye tracking controlled perimetric results revealed no statistically significant effect. Discussion Bright-light detection RT at the blind-field border solely induced a placebo effect and did not lead to training-induced neuroplasticity in the visual cortex of the type needed to ameliorate the visual field size of stroke patients.
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Affiliation(s)
- Michael Christian Leitner
- Salzburg University of Applied Sciences, Salzburg, Austria
- Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Anja-Maria Ladek
- Research Program for Experimental Ophthalmology and Glaucoma Research, Department of Ophthalmology and Optometry, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
- Department of Ophthalmology and Optometry, SALK, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Florian Hutzler
- Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Herbert Reitsamer
- Research Program for Experimental Ophthalmology and Glaucoma Research, Department of Ophthalmology and Optometry, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
- Department of Ophthalmology and Optometry, SALK, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Stefan Hawelka
- Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
- Department of Psychology, University of Salzburg, Salzburg, Austria
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English MCW, Maybery MT, Visser TAW. A review of behavioral evidence for hemispheric asymmetry of visuospatial attention in autism. Autism Res 2023. [PMID: 37243312 DOI: 10.1002/aur.2956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/14/2023] [Indexed: 05/28/2023]
Abstract
Most individuals show a small bias towards visual stimuli presented in their left visual field (LVF) that reflects right-hemispheric specialization of visuospatial functions. Moreover, this bias is altered by some neurodevelopmental disorders, suggesting they may be linked to changes in hemispheric asymmetry. To examine whether autism potentially alters hemispheric asymmetry, we conducted a systematic search of scientific databases to review existing literature on the link between autism and alterations in visuospatial bias. This search identified 13 publications that had explored this issue using a wide range of experimental designs and stimuli. Evidence of reduced LVF bias associated with autism was most consistent for studies examining attentional bias or preference measured using tasks such as line bisection. Findings for studies examining attentional performance (e.g., reaction time) were more equivocal. Further investigation is called for, and we make several recommendations for how this avenue of research can be extended.
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Affiliation(s)
- Michael C W English
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Murray T Maybery
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Troy A W Visser
- School of Psychological Science, University of Western Australia, Perth, Australia
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Hiew S, Roothans J, Eldebakey H, Volkmann J, Zeller D, Reich MM. Imaging the Spin: Disentangling the Core Processes Underlying Mental Rotation by Network Mapping of Data From Meta-analysis. Neurosci Biobehav Rev 2023; 150:105187. [PMID: 37086933 DOI: 10.1016/j.neubiorev.2023.105187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/05/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
Research on the mental rotation task has sparked debate regarding the specific processes that underly the capability of humans to mentally rotate objects. The spread of reported brain activations suggests that mental rotation is subserved by a neural network circle. However, no common network has yet been found that uncovers the crucial processes underlying this ability. We aimed to identify the common network crucial for mental rotation by coordinate-based network mapping of previous neuroimaging findings in mental rotation. A meta-analysis revealed 710 peak activation coordinates from 42 fMRI studies in mental rotation, which include a total 844 participants. The coordinates were mapped to a normative functional connectome (n = 1000) to identify a network of connected regions. To account for experimental factors, we examined this network against two control tasks, action imitation and symbolic number processing. A common and crucial network for mental rotation, centring on dorsal premotor, superior parietal and inferior temporal lobes was revealed. This network, separated from other experimental aspects, suggests that the crucial processes underlying mental rotation are motor rotation, visuospatial processing, and higher order visual object recognition.
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Affiliation(s)
- Shawn Hiew
- Department of Neurology, University Hospital of Würzburg, Germany.
| | - Jonas Roothans
- Department of Neurology, University Hospital of Würzburg, Germany
| | - Hazem Eldebakey
- Department of Neurology, University Hospital of Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital of Würzburg, Germany
| | - Daniel Zeller
- Department of Neurology, University Hospital of Würzburg, Germany
| | - Martin M Reich
- Department of Neurology, University Hospital of Würzburg, Germany
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Sakurai Y, Ohara N, Fukai Y, Seki Y, Akiyama K, Yoneoka Y, Takada T, Tani T, Terajima K, Ozawa T, Sone H. Hypoglycemic Hemiplegia Associated with Reversible Narrowing of the Contralateral Middle Cerebral Artery in a Patient with Adrenal Insufficiency. Intern Med 2023; 62:751-756. [PMID: 35871581 PMCID: PMC10037026 DOI: 10.2169/internalmedicine.0038-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 56-year-old man with a 2.5-month history of anorexia developed sweating, weakness, and left hemiplegia and hemispatial neglect. Brain magnetic resonance imaging detected no abnormalities, but magnetic resonance angiography revealed narrowing of the right middle cerebral artery (MCA). The focal neurological signs and narrowing of the MCA resolved after detection and correction of hypoglycemia. Endocrinological examinations indicated adrenal insufficiency. Hemiplegia is a rare but important neurological manifestation of hypoglycemia, although the mechanisms involved remain unknown. Combined hypoglycemia and decreased MCA blood flow associated with vasospasm probably induced regionally severe neuroglycopenia with ischemia, which presented as focal neurological symptoms.
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Affiliation(s)
- Yuhki Sakurai
- Department of Endocrinology and Metabolism, Uonuma Kikan Hospital, Japan
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Japan
| | - Nobumasa Ohara
- Department of Endocrinology and Metabolism, Uonuma Kikan Hospital, Japan
| | - Yumi Fukai
- Department of Endocrinology and Metabolism, Uonuma Kikan Hospital, Japan
| | - Yasuhiro Seki
- Department of Neurosurgery, Uonuma Kikan Hospital, Japan
| | | | | | - Toshinori Takada
- Department of Respiratory Medicine, Uonuma Kikan Hospital, Japan
| | - Takashi Tani
- Department of Neurology, Uonuma Kikan Hospital, Japan
| | | | | | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Japan
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Rodriguez-Hernandez A, Babici D, Campbell M, Carranza-Reneteria O, Hammond T. Hypoglycemic hemineglect a stroke mimic. eNeurologicalSci 2023; 30:100444. [PMID: 36698773 PMCID: PMC9869408 DOI: 10.1016/j.ensci.2023.100444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/31/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Acute hypoglycemia may mimic acute ischemic stroke, but to our knowledge this has never been reported as transient hemineglect syndrome. We present a 60-year-old male with known diabetes mellitus who was brought to the hospital as a stroke alert. The patient had undetectable glucose levels upon arrival of emergency medical services (EMS), therefore hypertonic glucose was given. On our assessment in the emergency department (ED)he turned his head to the right side, looking to the right to answer questions when addressed on his left side. The extinction and neglect assessment revealed left-sided extinction on double tactile and visual stimulation. CT perfusion of the brain showed a decreased perfusion in the right cortical area. Given the unclear last known normal, urgent brain magnetic resonance imaging (MRI) was performed; stroke was excluded. The patient was admitted to the Intensive Care Unit where glucose was closely monitored. Electroencephalogram showed absence of seizure or postictal activity. The following morning, the patient returned to baseline and was able to recall the event. The episode was attributed to the severe hypoglycemia because of a recent medication change.
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Affiliation(s)
| | - Denis Babici
- Corresponding author at: Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Road, BC-71, Boca Raton, FL 33431, United States.
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Ludwig D. The functions of consciousness in visual processing. Neurosci Conscious 2023; 2023:niac018. [PMID: 36628118 PMCID: PMC9825248 DOI: 10.1093/nc/niac018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/24/2022] [Accepted: 12/06/2022] [Indexed: 01/09/2023] Open
Abstract
Conscious experiences form a relatively diverse class of psychological phenomena, supported by a range of distinct neurobiological mechanisms. This diversity suggests that consciousness occupies a variety of different functional roles across different task domains, individuals, and species; a position I call functional pluralism. In this paper, I begin to tease out some of the functional contributions that consciousness makes to (human) visual processing. Consolidating research from across the cognitive sciences, I discuss semantic and spatiotemporal processing as specific points of comparison between the functional capabilities of the visual system in the presence and absence of conscious awareness. I argue that consciousness contributes a cluster of functions to visual processing; facilitating, among other things, (i) increased capacities for semantically processing informationally complex visual stimuli, (ii) increased spatiotemporal precision, and (iii) increased capacities for representational integration over large spatiotemporal intervals. This sort of analysis should ultimately yield a plurality of functional markers that can be used to guide future research in the philosophy and science of consciousness, some of which are not captured by popular theoretical frameworks like global workspace theory and information integration theory.
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Affiliation(s)
- Dylan Ludwig
- Department of Philosophy, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada
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Bazan R, Fonseca BHDS, Miranda JMDA, Nunes HRDC, Bazan SGZ, Luvizutto GJ. Effect of Robot-Assisted Training on Unilateral Spatial Neglect After Stroke: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Neurorehabil Neural Repair 2022; 36:545-556. [PMID: 35880666 DOI: 10.1177/15459683221110894] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Several studies have shown that robotic devices can effectively improve motor function in stroke patients through limb activation. However, the effects of robot-assisted therapy on perceptual deficits after stroke is unclear. OBJECTIVE This review aimed to evaluate the effectiveness of robotic limb activation in patients with unilateral spatial neglect (USN) after stroke. METHODS In this systematic review, a literature search was performed using MEDLINE, EMBASE, CENTRAL, CINAHL, and LILACS databases without language restrictions. Randomized controlled trials (RCTs) and quasi-RCTs of robot-assisted therapy for USN after stroke were selected. Two reviewers independently assessed the risk of bias and certainty of the evidence of the included studies. RESULTS A total of 630 studies were identified, including five studies for qualitative synthesis and four meta-analyses. The results of RCTs comparing robotic limb activation with a control group suggested an improvement in the degree of USN measured by the line bisection test (standardized mean difference [SMD], -0.64; 95% confidence interval [CI], -1.13 to -0.15; P = .01). There were no differences between the groups in the motor-free visual perception test 3rd edition (SMD, 0.27; 95% CI, -0.25-0.79; P = .31), star cancellation test (SMD, 0.26; 95% CI, -0.42-0.94; P = .54), Albert's test (SMD, -0.67; 95% CI, -2.01-0.66; P = .32), and Catherine Bergego Scale (SMD, -0.81; 95% CI, -2.07-0.45; P = .21). CONCLUSION The study demonstrated that limb activation through robotic therapy can improve midline perception. However, there was no impact on tasks assessing visual scanning, functionality, or activities of daily living.
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Affiliation(s)
- Rodrigo Bazan
- Department of Neurology, Psychology, and Psychiatry at Botucatu Medical School (UNESP), Botucatu, São Paulo, Brazil
| | | | | | | | | | - Gustavo José Luvizutto
- Department of Applied Physical Therapy-Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
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Akatsuka T, Yasuda K, Sabu R, Kawaguchi S, Iwata H. A Proposal for a New Index to Quantify the Ratio of Near and Far Spatial Neglect Using Immersive Virtual Reality Technology: A Technical Report. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:4151-4154. [PMID: 36086512 DOI: 10.1109/embc48229.2022.9871683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Unilateral spatial neglect (USN) is defined as impaired attention to sensory stimuli on one side, which can exist for near and far spaces combined or independently. Thus, quantifying both near- and far-space neglect is crucial. This study aims to propose an index to quantify the near/far spatial neglect ratio to describe the USN symptoms' characteristics in each patient using immersive virtual reality (VR) technology. An object-detecting task was performed for five USN patients in a three-dimensional VR space. The examiner recorded the positional data of the objects that were recognized by the USN patient using coordinate data. The near/far ratio (NFRatio) was calculated using the proposed equation to quantify the difference in neglect severity in near and far spaces of each patient. Among the patients, four tended to have greater far-space neglect, and one tended to have greater near-space neglect. Moreover, the near/far spatial neglect ratio was shown to vary according to height. This is the first study to propose immersive VR to quantify the near and far spatial neglect. However, further study is needed to assess its reliability and validity and describe its clinical usability. Clinical Relevance- In clinical practice USN symptoms cause neglected symptoms in 3D space so the proposed system will be of high clinical significance if 3D assessment is realized.
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Takazawa S, Yasuda K, Sabu R, Kawaguchi S, Iwata H. Quantification of Unilateral Spatial Neglect Symptoms Based on Identification of Exploratory Ability. IEEE Int Conf Rehabil Robot 2022; 2022:1-5. [PMID: 36176126 DOI: 10.1109/icorr55369.2022.9896489] [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: 06/16/2023]
Abstract
Unilateral spatial neglect (USN) is the failure to report, respond, or orient to novel or meaningful stimuli presented on the side opposite a brain lesion. In our previous study, we reported that the ability of patients with USN to perform when the neck was fixed (called cognitive ability) was different from that when the neck was not fixed (called exploratory ability). However, the exploratory ability index has not been clarified, and cognitive and exploratory abilities have not been quantified. Thus, in this study, we identified neck movement as an exploratory ability index for patients with USN. Furthermore, we proposed equations to quantify cognitive and exploratory abilities and suggested that these equations can be used to understand patients' neglect symptoms in more detail. These findings revealed that the two evaluations of cognitive and exploratory abilities are crucial in USN evaluation and are key to individualizing intervention for each patient.
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15
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Olgiati E, Malhotra PA. Using non-invasive transcranial direct current stimulation for neglect and associated attentional deficits following stroke. Neuropsychol Rehabil 2022; 32:732-763. [PMID: 32892712 DOI: 10.1080/09602011.2020.1805335] [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: 10/23/2022]
Abstract
Neglect is a disabling neuropsychological syndrome that is frequently observed following right-hemispheric stroke. Affected individuals often present with multiple attentional deficits, ranging from reduced orienting towards contralesional space to a generalized impairment in maintaining attention over time. Although a degree of spontaneous recovery occurs in most patients, in some individuals this condition can be treatment-resistant with prominent ongoing non-spatial deficits. Further, there is a large inter-individual variability in response to different therapeutic approaches. Given its potential to alter neuronal excitability and affect neuroplasticity, non-invasive brain stimulation is a promising tool that could potentially be utilized to facilitate recovery. However, there are many outstanding questions regarding its implementation in this heterogeneous patient group. Here we provide a critical overview of the available evidence on the use of non-invasive electrical brain stimulation, focussing on transcranial direct current stimulation (tDCS), to improve neglect and associated attentional deficits after right-hemispheric stroke. At present, there is insufficient robust evidence supporting the clinical use of tDCS to alleviate symptoms of neglect. Future research would benefit from careful study design, enhanced precision of electrical montages, multi-modal approaches exploring predictors of response, tailored dose-control applications and increased efforts to evaluate standalone tDCS versus its incorporation into combination therapy.
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Affiliation(s)
- Elena Olgiati
- Department of Brain Sciences, Imperial College London, London, UK.,Imperial College Healthcare NHS Trust, London, UK
| | - Paresh A Malhotra
- Department of Brain Sciences, Imperial College London, London, UK.,Imperial College Healthcare NHS Trust, London, UK.,UK Dementia Research Institute, Care Research & Technology Centre, Imperial College London and University of Surrey, London, UK
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16
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Knobel SEJ, Kaufmann BC, Geiser N, Gerber SM, Müri RM, Nef T, Nyffeler T, Cazzoli D. Effects of Virtual Reality-Based Multimodal Audio-Tactile Cueing in Patients With Spatial Attention Deficits: Pilot Usability Study. JMIR Serious Games 2022; 10:e34884. [PMID: 35612894 PMCID: PMC9178455 DOI: 10.2196/34884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/17/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Virtual reality (VR) devices are increasingly being used in medicine and other areas for a broad spectrum of applications. One of the possible applications of VR involves the creation of an environment manipulated in a way that helps patients with disturbances in the spatial allocation of visual attention (so-called hemispatial neglect). One approach to ameliorate neglect is to apply cross-modal cues (ie, cues in sensory modalities other than the visual one, eg, auditory and tactile) to guide visual attention toward the neglected space. So far, no study has investigated the effects of audio-tactile cues in VR on the spatial deployment of visual attention in neglect patients. OBJECTIVE This pilot study aimed to investigate the feasibility and usability of multimodal (audio-tactile) cueing, as implemented in a 3D VR setting, in patients with neglect, and obtain preliminary results concerning the effects of different types of cues on visual attention allocation compared with noncued conditions. METHODS Patients were placed in a virtual environment using a head-mounted display (HMD). The inlay of the HMD was equipped to deliver tactile feedback to the forehead. The task was to find and flag appearing birds. The birds could appear at 4 different presentation angles (lateral and paracentral on the left and right sides), and with (auditory, tactile, or audio-tactile cue) or without (no cue) a spatially meaningful cue. The task usability and feasibility, and 2 simple in-task measures (performance and early orientation) were assessed in 12 right-hemispheric stroke patients with neglect (5 with and 7 without additional somatosensory impairment). RESULTS The new VR setup showed high usability (mean score 10.2, SD 1.85; maximum score 12) and no relevant side effects (mean score 0.833, SD 0.834; maximum score 21). A repeated measures ANOVA on task performance data, with presentation angle, cue type, and group as factors, revealed a significant main effect of cue type (F30,3=9.863; P<.001) and a significant 3-way interaction (F90,9=2.057; P=.04). Post-hoc analyses revealed that among patients without somatosensory impairment, any cue led to better performance compared with no cue, for targets on the left side, and audio-tactile cues did not seem to have additive effects. Among patients with somatosensory impairment, performance was better with both auditory and audio-tactile cueing than with no cue, at every presentation angle; conversely, tactile cueing alone had no significant effect at any presentation angle. Analysis of early orientation data showed that any type of cue triggered better orientation in both groups for lateral presentation angles, possibly reflecting an early alerting effect. CONCLUSIONS Overall, audio-tactile cueing seems to be a promising method to guide patient attention. For instance, in the future, it could be used as an add-on method that supports attentional orientation during established therapeutic approaches.
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Affiliation(s)
| | - Brigitte Charlotte Kaufmann
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute (ICM), Inserm, Centre national de la recherche scientifique, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Nora Geiser
- Neurocenter, Luzerner Kantonsspital, Luzern, Switzerland
| | | | - René M Müri
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tobias Nef
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Thomas Nyffeler
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,Neurocenter, Luzerner Kantonsspital, Luzern, Switzerland.,Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Dario Cazzoli
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,Neurocenter, Luzerner Kantonsspital, Luzern, Switzerland.,Institute of Psychology, University of Bern, Bern, Switzerland
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Implementing New Technologies to Improve Visual-Spatial Functions in Patients with Impaired Consciousness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053081. [PMID: 35270773 PMCID: PMC8910167 DOI: 10.3390/ijerph19053081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 01/13/2023]
Abstract
The quality of life of patients with severe brain damage is compromised by, e.g., impaired cognitive functions and ocular dysfunction. The paper contains research findings regarding participants of an oculomotor training course aimed at the therapy of visual-spatial functions. Five male patients with brain damage who did not communicate, verbally or motorically, participated in the study. Over a six-week period, the subjects solved tasks associated with recognising objects, size perception, colour perception, perception of object structures (letters), perception of object structures (objects), detecting differences between images and assembling image components into the complete image with the use of an eye tracker. The findings present evidence of oculomotor training effectiveness based on a longer duration of the work with the eye tracker and improved visual-spatial functions.
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18
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From Patient to Musician: A Multi-Sensory Virtual Reality Rehabilitation Tool for Spatial Neglect. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Unilateral Spatial Neglect (USN) commonly results from a stroke or acquired brain injury. USN affects multiple modalities and results in failure to respond to stimuli on the contralesional side of space. Although USN is a heterogeneous syndrome, present-day therapy methods often fail to consider multiple modalities. Musical Neglect Therapy (MNT) is a therapy method that succeeds in incorporating multiple modalities by asking patients to make music. This research aimed to exploit the immersive and modifiable aspect of VR to translate MNT to a VR therapy tool. The tool was evaluated in a 2-week pilot study with four clinical users. These results are compared to a control group of four non-clinical users. Results indicated that patients responded to triggers in their entire environment and performance results could be clearly differentiated between clinical and non-clinical users. Moreover, patients increasingly corrected their head direction towards their neglected side. Patients stated that the use of VR increased their enjoyment of the therapy. This study contributes to the current research on rehabilitation for USN by proposing the first system to apply MNT in a VR environment. The tool shows promise as an addition to currently used rehabilitation methods. However, results are limited to a small sample size and performance metrics. Future work will focus on validating these results with a larger sample over a longer period. Moreover, future efforts should explore personalisation and gamification to tailor to the heterogeneity of the condition.
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Williams LJ, Kernot J, Hillier SL, Loetscher T. Spatial Neglect Subtypes, Definitions and Assessment Tools: A Scoping Review. Front Neurol 2021; 12:742365. [PMID: 34899565 PMCID: PMC8653914 DOI: 10.3389/fneur.2021.742365] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/14/2021] [Indexed: 12/03/2022] Open
Abstract
Objective: The objective of this scoping review was to capture the reported definitions for the subtypes of neglect post stroke and map the range of assessment tools employed for each neglect subtype. Methods: EMBASE, Emcare, Medline, and psychINFO were searched from database inception. Searching included all allied terms and mesh headings for stroke, spatial neglect, measurement, screening tools, psychometric properties. Two reviewers independently screened studies for inclusion. Primary studies with documented protocols of a spatial neglect tool for adults post stroke, with some aspect of validity or reliability were included. Two reviewers independently reviewed the documented protocols of each tool to determine the underlying subtypes and disagreements were resolved through discussion. Results: There were 371 articles included with 292 tools used for the screening or diagnosis of neglect. The majority of studies (67%) included a tool that did not specify the neglect subtype being assessed, therefore an analysis of the underlying subtypes for each tool is presented. Conclusions: There is no consistency with the terms used to refer to the syndrome of spatial neglect with over 200 different terms used within the included studies to refer to the syndrome as a whole or one of its subtypes. It is essential to unify the terminology and definition for each neglect subtype. There are hundreds of neglect tools available, however many are not able to differentiate presenting subtypes. It is important for clinicians and researchers to critically evaluate the neglect tools being used for the screening and diagnosis of neglect.
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Affiliation(s)
- Lindy J Williams
- Cognitive Aging and Impairment Neurosciences Lab, University of South Australia, Adelaide, SA, Australia.,Innovation IMPlementation and Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, SA, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Jocelyn Kernot
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Susan L Hillier
- Innovation IMPlementation and Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, SA, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Tobias Loetscher
- Cognitive Aging and Impairment Neurosciences Lab, University of South Australia, Adelaide, SA, Australia.,Justice and Society, University of South Australia, Adelaide, SA, Australia
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20
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Psychiatric sequelae of stroke affecting the non-dominant cerebral hemisphere. J Neurol Sci 2021; 430:120007. [PMID: 34624794 DOI: 10.1016/j.jns.2021.120007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/08/2023]
Abstract
There are a plethora of cognitive sequelae in addition to neglect and extinction that arise with unilateral right hemispheric stroke (RHS). Cognitive deficits following non-dominant (right) hemisphere stroke are common with unilateral neglect and extinction being the most recognized examples. The severity of RHS is usually underestimated by the National Institutes of Health Stroke Scale (NIHSS), which in terms of lateralized right hemisphere cognitive deficits, tests only for visual inattention/extinction. They account for 2 out of 42 total possible points. Additional neuropsychiatric sequelae include but are not limited to deficiencies in affective prosody comprehension and production (aprosodias), understanding and expressing facial emotions, empathy, recognition of familiar faces, anxiety, mania, apathy, and psychosis. These sequelae have a profound impact on patients' quality of life; affecting communication, interpersonal relationships, and the ability to fulfill social roles. They also pose additional challenges to recovery. There is presently a gap in the literature regarding a cohesive overview of the significant cognitive sequelae following RHS. This paper serves as a narrative survey of the current understanding of the subject, with particular emphasis on neuropsychiatric poststroke syndromes not predominantly associated with left hemisphere lesions (LHL), bilateral lesions, hemiplegia, or paralysis. A more comprehensive understanding of the neuropsychological consequences of RHS extending beyond the typical associations of unilateral neglect and extinction may have important implications for clinical practice, including the ways in which clinicians approach diagnostics, treatment, and rehabilitation.
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21
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Kocanaogullari D, Huang X, Mak J, Shih M, Skidmore E, Wittenberg GF, Ostadabbas S, Akcakaya M. Fine-tuning and Personalization of EEG-based Neglect Detection in Stroke Patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:1096-1099. [PMID: 34891478 DOI: 10.1109/embc46164.2021.9630794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Spatial neglect (SN) is a neurological disorder that causes inattention to visual stimuli in the contralesional visual field, stemming from unilateral brain injury such as stroke. The current gold standard method of SN assessment, the conventional Behavioral Inattention Test (BIT-C), is highly variable and inconsistent in its results. In our previous work, we built an augmented reality (AR)-based BCI to overcome the limitations of the BIT-C and classified between neglected and non-neglected targets with high accuracy. Our previous approach included personalization of the neglect detection classifier but the process required rigorous retraining from scratch and time-consuming feature selection for each participant. Future steps of our work will require rapid personalization of the neglect classifier; therefore, in this paper, we investigate fine-tuning of a neural network model to hasten the personalization process.
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22
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Wyatt LE, Champod AS, Haidar GM, Eskes GA. Can prism adaptation effects generalize to wheelchair maneuvering? NeuroRehabilitation 2021; 49:119-128. [PMID: 33998553 DOI: 10.3233/nre-210028] [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: 11/15/2022]
Abstract
BACKGROUND While prism adaptation (PA) has been recognized as a promising tool for treating spatial neglect, implementation as a standard treatment in clinical care has been lagging. Limited evidence for the generalization of after-effects to everyday activities has been a barrier towards implementation. OBJECTIVES This study examined whether a home-friendly standardized PA protocol (Peg-the-Mole, PTM) induces after-effects that can transfer to wheelchair maneuvering. We also examined the impact of using constant (1 starting hand position) or variable (3 starting hand positions) training conditions on the transfer of after-effects to wheelchair maneuvering. METHODS Sixty participants were randomly assigned to one of four PTM conditions: 1) prisms/constant training; 2) prisms/variable training; 3) sham goggles/constant training; 4) sham goggles/variable training. RESULTS The use of PTM with rightward shifting prisms induced after-effects on proprioceptive and visual pointing outcome tasks. Groups using PTM with prism goggles showed a leftward shift in their position within a wheelchair course and a reduction in the number of right-sided collisions. The training condition did not have an impact on the transfer of after-effects to wheelchair driving. CONCLUSION PTM is a clinically appealing PA protocol that induces after-effects that can transfer to an everyday activity relevant to patients with neglect.
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Affiliation(s)
- Lindsay E Wyatt
- Department of Psychology, Acadia University, Wolfville, Nova Scotia, Canada
| | - Anne Sophie Champod
- Department of Psychology, Acadia University, Wolfville, Nova Scotia, Canada.,Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gabrielle M Haidar
- Department of Psychology, Acadia University, Wolfville, Nova Scotia, Canada.,School of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Gail A Eskes
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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23
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De-Rosende-Celeiro I, Rey-Villamayor A, Francisco-de-Miguel I, Ávila-Álvarez A. Independence in Daily Activities after Stroke among Occupational Therapy Patients and Its Relationship with Unilateral Neglect. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7537. [PMID: 34299988 PMCID: PMC8306679 DOI: 10.3390/ijerph18147537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022]
Abstract
More research is needed to better understand the impact of occupational therapy (OT) in stroke patients and syndromes of unilateral neglect (UN) and anosognosia. A prospective, observational, longitudinal design was conducted on a sample of 27 OT patients. The objectives were to examine: (1) the presence of UN and anosognosia; (2) the functional outcomes; and (3) the association of UN at baseline with functional status at discharge from OT. The outcomes were Barthel (functional independence) and the Rivermead Mobility Index (RMI). The baseline proportion of participants with UN was 33% according to the Star Cancellation Test (STC), and 48.1% according to the Catherine Bergego Scale (CBS) therapist-version. There was a significant difference between the therapist and participant-rated CBS scores (p = 0.004). Functional independence improved significantly between the initial and final assessments (p < 0.001); the effect size (r) was large (r = 0.61). There was a significant improvement in RMI scores (p < 0.001), which was large in size (r = 0.59). Both the STC and CBS-therapist scores were significantly correlated with the Barthel (p < 0.001, p = 0.005, respectively) and with the RMI (p = 0.004, p = 0.028, respectively). The participants substantially enhanced their functional status skills. UN and anosognosia were common problems, and neglect was associated with worse OT program outcomes.
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Affiliation(s)
- Iván De-Rosende-Celeiro
- Occupational Therapy Research Unit in Non-Pharmacological Interventions, University of A Coruña, 15071 A Coruña, Spain;
| | | | | | - Adriana Ávila-Álvarez
- Occupational Therapy Research Unit in Non-Pharmacological Interventions, University of A Coruña, 15071 A Coruña, Spain;
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Provocation and prediction of visual peripersonal neglect-like symptoms in preoperative planning and during awake brain surgery. Acta Neurochir (Wien) 2021; 163:1941-1947. [PMID: 33821318 PMCID: PMC8195910 DOI: 10.1007/s00701-021-04822-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/18/2021] [Indexed: 11/15/2022]
Abstract
Neglect is a severe neuropsychological/neurological deficit that usually develops due to lesions of the posterior inferior parietal area of the right hemisphere and is characterized by a lack of attention to the left side. Our case is a proven right-handed, 30-year-old female patient with a low-grade glioma, which was located in the temporo-opercular region and also in the superior temporal gyrus of the right hemisphere. Upon presurgical planning, the motor, language, and visuospatial functions were mapped. In order to achieve this, the protocol for routine magnetic resonance imaging and navigated transcranial magnetic stimulation has been expanded, accordingly.
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25
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Thibaut A, Panda R, Annen J, Sanz LRD, Naccache L, Martial C, Chatelle C, Aubinet C, Bonin EAC, Barra A, Briand MM, Cecconi B, Wannez S, Stender J, Laureys S, Gosseries O. Preservation of Brain Activity in Unresponsive Patients Identifies MCS Star. Ann Neurol 2021; 90:89-100. [PMID: 33938027 PMCID: PMC8252577 DOI: 10.1002/ana.26095] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 01/18/2023]
Abstract
Objective Brain‐injured patients who are unresponsive at the bedside (ie, vegetative state/unresponsive wakefulness syndrome – VS/UWS) may present brain activity similar to patients in minimally conscious state (MCS). This peculiar condition has been termed “non‐behavioural MCS” or “MCS*”. In the present study we aimed to investigate the proportion and underlying brain characteristics of patients in MCS*. Methods Brain 18F‐fluorodeoxyglucose Positron Emission Tomography (FDG‐PET) was acquired on 135 brain‐injured patients diagnosed in prolonged VS/UWS (n = 48) or MCS (n = 87). From an existing database, relative metabolic preservation in the fronto‐parietal network (measured with standardized uptake value) was visually inspected by three experts. Patients with hypometabolism of the fronto‐parietal network were labelled “VS/UWS”, while its (partial) preservation either confirmed the behavioural diagnosis of “MCS” or, in absence of behavioural signs of consciousness, suggested a diagnosis of “MCS*”. Clinical outcome at 1‐year follow‐up, functional connectivity, grey matter atrophy, and regional brain metabolic patterns were investigated in the three groups (VS/UWS, MCS* and MCS). Results 67% of behavioural VS/UWS presented a partial preservation of brain metabolism (ie, MCS*). Compared to VS/UWS patients, MCS* patients demonstrated a better outcome, global functional connectivity and grey matter preservation more compatible with the diagnosis of MCS. MCS* patients presented lower brain metabolism mostly in the posterior brain regions compared to MCS patients. Interpretation MCS* is a frequent phenomenon that is associated with better outcome and better brain preservation than the diagnosis of VS/UWS. Complementary exams should be provided to all unresponsive patients before taking medical decisions. ANN NEUROL 2021;90:89–100
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Affiliation(s)
- Aurore Thibaut
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Rajanikant Panda
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Jitka Annen
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Leandro R D Sanz
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Lionel Naccache
- PICNIC Lab, Institut du cerveau, INSERM U1127, Sorbonne Université, Paris, France
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Camille Chatelle
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Charlène Aubinet
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Estelle A C Bonin
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Alice Barra
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Marie-Michèle Briand
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Benedetta Cecconi
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Sarah Wannez
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Johan Stender
- Department of Neurology, Bispebjerg Hospital, Copenhagen, Denmark
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
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Adam R, Schaeffer DJ, Johnston K, Menon RS, Everling S. Structural alterations in cortical and thalamocortical white matter tracts after recovery from prefrontal cortex lesions in macaques. Neuroimage 2021; 232:117919. [PMID: 33652141 DOI: 10.1016/j.neuroimage.2021.117919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 01/04/2023] Open
Abstract
Unilateral damage to the frontoparietal network typically impairs saccade target selection within the contralesional visual hemifield. Severity of deficits and the degree of recovery have been associated with widespread network dysfunction, yet it is not clear how these behavioural and functional brain changes relate with the underlying structural white matter tracts. Here, we investigated whether recovery after unilateral prefrontal cortex (PFC) lesions was associated with changes in white matter microstructure across large-scale frontoparietal cortical and thalamocortical networks. Diffusion-weighted imaging was acquired in four male rhesus macaques at pre-lesion, week 1, and week 8-16 post-lesion when target selection deficits largely recovered. Probabilistic tractography was used to reconstruct cortical frontoparietal fiber tracts, including the superior longitudinal fasciculus (SLF) and transcallosal fibers connecting the PFC or posterior parietal cortex (PPC), as well as thalamocortical fiber tracts connecting the PFC and PPC to thalamic nuclei. We found that the two animals with small PFC lesions showed increased fractional anisotropy in both cortical and thalamocortical fiber tracts when behaviour had recovered. However, we found that fractional anisotropy decreased in cortical frontoparietal tracts after larger PFC lesions yet increased in some thalamocortical tracts at the time of behavioural recovery. These findings indicate that behavioural recovery after small PFC lesions may be supported by both cortical and subcortical areas, whereas larger PFC lesions may have induced widespread structural damage and hindered compensatory remodeling in the cortical frontoparietal network.
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Affiliation(s)
- Ramina Adam
- Graduate Program in Neuroscience, University of Western Ontario, London, Canada; Robarts Research Institute, University of Western Ontario, London, Canada; The Brain and Mind Institute, University of Western Ontario, London, Canada
| | - David J Schaeffer
- Department of Neurobiology, University of Pittsburgh, PA, United States
| | - Kevin Johnston
- The Brain and Mind Institute, University of Western Ontario, London, Canada; Department of Physiology and Pharmacology, University of Western Ontario, London, Canada
| | - Ravi S Menon
- Robarts Research Institute, University of Western Ontario, London, Canada; The Brain and Mind Institute, University of Western Ontario, London, Canada; Department of Medical Biophysics, University of Western Ontario, London, Canada
| | - Stefan Everling
- Graduate Program in Neuroscience, University of Western Ontario, London, Canada; Robarts Research Institute, University of Western Ontario, London, Canada; The Brain and Mind Institute, University of Western Ontario, London, Canada; Department of Physiology and Pharmacology, University of Western Ontario, London, Canada.
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27
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Abstract
This paper presents a novel bio-inspired predictive model of visual navigation inspired by mammalian navigation. This model takes inspiration from specific types of neurons observed in the brain, namely place cells, grid cells and head direction cells. In the proposed model, place cells are structures that store and connect local representations of the explored environment, grid and head direction cells make predictions based on these representations to define the position of the agent in a place cell’s reference frame. This specific use of navigation cells has three advantages: First, the environment representations are stored by place cells and require only a few spatialized descriptors or elements, making this model suitable for the integration of large-scale environments (indoor and outdoor). Second, the grid cell modules act as an efficient visual and absolute odometry system. Finally, the model provides sequential spatial tracking that can integrate and track an agent in redundant environments or environments with very few or no distinctive cues, while being very robust to environmental changes. This paper focuses on the architecture formalization and the main elements and properties of this model. The model has been successfully validated on basic functions: mapping, guidance, homing, and finding shortcuts. The precision of the estimated position of the agent and the robustness to environmental changes during navigation were shown to be satisfactory. The proposed predictive model is intended to be used on autonomous platforms, but also to assist visually impaired people in their mobility.
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28
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Kim TL, Kim K, Choi C, Lee JY, Shin JH. FOPR test: a virtual reality-based technique to assess field of perception and field of regard in hemispatial neglect. J Neuroeng Rehabil 2021; 18:39. [PMID: 33602254 PMCID: PMC7890954 DOI: 10.1186/s12984-021-00835-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 02/07/2021] [Accepted: 02/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We previously proposed a novel virtual reality-based method to assess human field of perception (FOP) and field of regard (FOR), termed the FOPR test. This study assessed the diagnostic validity of the FOPR test for hemispatial neglect (HSN). METHODS We included 19 stroke patients with a lesion in the right hemisphere and with HSN (HSN+SS), 22 stroke patients with a lesion in the right hemisphere and without HSN (HSN-SS), and 22 healthy controls aged 19-65 years. The success rate (SR) and response time (RT) in the FOPR test for both FOP and FOR were assessed (FOP-SR, FOR-SR, FOP-RT, and FOR-RT, respectively). Using a Bland-Altman plot, agreements between the FOPR test and conventional tests were confirmed, and the FOPR test accuracy was verified using the support vector machine (SVM). Measured values were analysed using ANOVA and Kruskall-Wallis tests for group comparison. RESULTS The Bland-Altman plot showed good agreement between FOPR test and conventional tests; individuals within 95% agreement limits were within the range of 94.8-100.0%. The SVM classification accuracy, using FOP and FOR variables from the left hemispace, ranged from 83.3 to 100.0% in a binary classification (HSN vs non-HSN). The FOPR test demonstrated differences in SR and RT for both FOP and FOR across the groups. CONCLUSION The FOPR test was valid for the HSN diagnosis and provided quantitative and intuitive information regarding visuospatial function. Furthermore, it might enhance our understanding of visuospatial function including HSN by applying the time relative component and concepts of perception and exploration, FOP and FOR. TRIAL REGISTRATION NCT03463122. Registered 13 March 2018, retrospectively registered.
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Affiliation(s)
- Tae-Lim Kim
- Department of Rehabilitation Medicine, National Rehabilitation Center, Ministry of Health and Welfare, Seoul, Republic of Korea
| | - Kwanguk Kim
- Department of Computer Science, Hanyang University, Seoul, Republic of Korea
| | - Changyeol Choi
- Department of Computer Science, Hanyang University, Seoul, Republic of Korea
| | - Ji-Yeong Lee
- Department of Rehabilitation Medicine, National Rehabilitation Center, Ministry of Health and Welfare, Seoul, Republic of Korea
| | - Joon-Ho Shin
- Department of Rehabilitation Medicine, National Rehabilitation Center, Ministry of Health and Welfare, Seoul, Republic of Korea.
- Department of Neurorehabilitation, National Rehabilitation Center, 58, Samgaksan-ro, Gangbuk-gu, Seoul, 01022, Republic of Korea.
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29
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Bhatnagar K, Bever CT, Tian J, Zhan M, Conroy SS. Comparing Home Upper Extremity Activity with Clinical Evaluations of Arm Function in Chronic Stroke. Arch Rehabil Res Clin Transl 2020; 2:100048. [PMID: 33336184 PMCID: PMC7739859 DOI: 10.1016/j.arrct.2020.100048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine if clinical evaluations of post-stroke arm function correspond to everyday motor performance indexed by arm accelerometers. DESIGN Cross-sectional study analyzing baseline data from a larger trial (NCT02665052). SETTING Outpatient research center. PARTICIPANTS Twenty community-dwelling adults with chronic arm motor deficits (stroke≥6mo). INTERVENTION 72-hours of home wrist-worn accelerometry during normal routine. MAIN OUTCOME MEASURES Clinical evaluations included the Fugl-Meyer (FM), Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), and two self-assessments: the Motor Activity Log (MAL) and hand motor subscale of the Stroke Impact Scale (SIS). Accelerometer-derived variables included quantifications of movement intensity (magnitude) and duration of arm use. RESULTS Participants had moderate arm impairment (FM 36.1 ± 9.4). The accelerometer-derived mean magnitude ratio correlated significantly with the FM (ρ = 0.60, p < 0.01), WMFT functional score (ρ = 0.59, p < 0.01), and ARAT (ρ = 0.50, p < 0.05). The hours of use ratio correlated with the MAL amount of use (ρ = 0.58, p < 0.01) and quality of movement (ρ = 0.61, p < 0.01). Total paretic hours did not correlate with the FM, WMFT or ARAT, and intensity variables did not correlate with the MAL or SIS. CONCLUSIONS Participants with higher baseline function had greater intensity of paretic arm movement at home; similarly, those who perceived they had less disability used their paretic arm more relative to their non-paretic arm. However, some participants with higher clinical scores did not exhibit greater arm use in everyday life, possibly due to neglect and learned non-use. Therefore, individualized home accelerometry profiles could provide valuable insight to better tailor post-stroke rehabilitation.
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Affiliation(s)
| | - Christopher T. Bever
- Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland
- VA Maryland Health Care System, Baltimore Veterans Affairs Medical Center, Baltimore, Maryland
| | - Jing Tian
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Min Zhan
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Susan S. Conroy
- VA Maryland Health Care System, Baltimore Veterans Affairs Medical Center, Baltimore, Maryland
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30
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Yasuda K, Kato R, Sabu R, Kawaguchi S, Iwata H. Development and proof of concept of an immersive virtual reality system to evaluate near and far space neglect in individuals after stroke: A brief report. NeuroRehabilitation 2020; 46:595-601. [PMID: 32508332 DOI: 10.3233/nre-203014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Unilateral spatial neglect (USN) is defined as impaired attention to sensory stimuli on one side. The symptoms can exist for near and far spaces combined or independently. Thus, it is important to evaluate both possibilities in a clinical environment. OBJECTIVE To develop a tractable immersive virtual reality (iVR) system that can evaluate both near and far space neglect along with a proof of concept study to determine whether near and far spatial neglect could be described in an actual patient with USN. METHODS An object-detecting task was developed in a three-dimensional virtual reality space. The examiner recorded the positional data of objects that were recognized by the patient with USN using coordinate data. RESULTS The system could be used to detect near and far space neglects in a patient with USN. No side effects such as vertigo were seen during measurement. This patient showed that the angle for recognition was significantly larger for near space than far space, and exhibited a tendency for the angle of recognition to increase with lower height. CONCLUSIONS Our proof of concept study indicated the possibility of applying an evaluation system that separates far and near space neglect using iVR.
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Affiliation(s)
- Kazuhiro Yasuda
- Research Institute for Science and Engineering, Waseda University, Tokyo Japan
| | - Ryoichi Kato
- Department of Modern Mechanical Engineering, Waseda University, Tokyo, Japan
| | - Rikushi Sabu
- Department of Modern Mechanical Engineering, Waseda University, Tokyo, Japan
| | - Shuntaro Kawaguchi
- Department of Rehabilitation, Sonoda Rehabilitation Hospital, Tokyo, Japan
| | - Hiroyasu Iwata
- Graduate School of Creative Science and Engineering, Waseda University, Tokyo, Japan
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31
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Kriegler C, Cruz MT, Sun G, Friedrich TE, Elias LJ, Mickleborough MJS. Evidence for abnormal visuospatial attentional processes in the interictal migraineur. Laterality 2020; 25:583-598. [PMID: 32508228 DOI: 10.1080/1357650x.2020.1776311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Research shows decreased brain region activity in the right temporo-parietal junction (rTPJ) in people with migraine headache relative to headache-free controls when performing an orienting visuospatial attention task. Functional inactivation of the rTPJ has been associated with rightward performance deviations on laterality-based attention Landmark (LM) and greyscale (GRE) tasks in individuals with unilateral neglect and heightened activation in the rTPJ is associated with leftward deviation, known as pseudoneglect, in controls on these tasks. Given this, we investigated whether migraineurs would lack the leftward deviation found in headache-free controls on visuospatial attention tasks. 36 migraineurs and 38 controls were presented with LM and GRE tasks. Response bias scores showed a significant difference in responses between groups (p = 0.036) on the GRE, a luminance-based task, but not on the LM, a size-based task (p = 0.826). This study is the first to show laterality-based attentional differences in migraineurs, as compared to controls. Specifically, migraineurs were found to have smaller leftward biases on luminance-based visuospatial attention tasks, as compared to controls, aligning with previous research suggesting that migraine may be having an impact on a variety of attention tasks in migraineurs in between headache attacks.
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Affiliation(s)
- Conley Kriegler
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Maria T Cruz
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
| | - Gloria Sun
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Lorin J Elias
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
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32
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Knobel SEJ, Kaufmann BC, Gerber SM, Cazzoli D, Müri RM, Nyffeler T, Nef T. Immersive 3D Virtual Reality Cancellation Task for Visual Neglect Assessment: A Pilot Study. Front Hum Neurosci 2020; 14:180. [PMID: 32528265 PMCID: PMC7263018 DOI: 10.3389/fnhum.2020.00180] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 04/22/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Unilateral spatial neglectis an attention disorder frequently occurring after a right-hemispheric stroke. Neglect results in a reduction in qualityof life and performance in activities of daily living. With current technical improvements in virtual reality (VR) technology, trainingwith stereoscopic head-mounted displays (HMD) has become a promising new approach for the assessment and the rehabilitation of neglect. The focus of this pilot study was to develop and evaluate a simple visual search task in VR for HMD. The VR system was tested regarding feasibility, acceptance, and potential adverse effects in healthy controls and right-hemispheric stroke patients with and without neglect. Methods: The VR system consisted of two main components, a head-mounted display to present the virtual environment, and a hand-held controller for the interaction with the latter. The task followed the rationale of diagnostic paper-pencil cancellation tasks; i.e., the participants were asked to search targets among distractors. However, instead of a two-dimensional setup, the targets and distractors were arranged in three dimensions, in a sphere around the subject inside its field of view. Usability and acceptance of the task, as well as the performance in the latter, were tested in 15 right-hemispheric subacute stroke patients (10 of whom with and five of whom without unilateral spatial neglect; mean age: 67.1 ± 10.5 years) and 35 age-matched healthy controls. Results: System usability and acceptance were rated as high both in stroke patients and healthy controls, close to the maximum score of the questionnaire scale. No relevant adverse effects occurred. There was a high correlation (r = 0.854, p = 0.002) between the Center of Cancellation [an objective neglect measure) calculated from a paper-pencil cancellation task (Sensitive Neglect Test (SNT)] and the newly developed VR cancellation task. Conclusion: Overall, the developed visual search task in the tested VR system is feasible, well-accepted, enjoyable, and does not evoke any significant negative effects, both for healthy controls and for stroke patients. Findings for task performance show that the ability of the VR cancellation to detect neglect in stroke patients is similar to paper-pencil cancellation tasks.
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Affiliation(s)
- Samuel E J Knobel
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
| | - Brigitte C Kaufmann
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Stephan M Gerber
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
| | - Dario Cazzoli
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland.,ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - René M Müri
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland.,Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas Nyffeler
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland.,Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Tobias Nef
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland.,ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
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33
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Hammerbeck U, Gittins M, Vail A, Paley L, Tyson SF, Bowen A. Spatial Neglect in Stroke: Identification, Disease Process and Association with Outcome During Inpatient Rehabilitation. Brain Sci 2019; 9:brainsci9120374. [PMID: 31847166 PMCID: PMC6956021 DOI: 10.3390/brainsci9120374] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/21/2019] [Accepted: 12/11/2019] [Indexed: 11/17/2022] Open
Abstract
We established spatial neglect prevalence, disease profile and amount of therapy that inpatient stroke survivors received, and outcomes at discharge using Sentinel Stroke National Audit Programme (SSNAP) data. We used data from 88,664 National Health Service (NHS) admissions in England, Wales and Northern Ireland (July 2013–July 2015), for stroke survivors still in hospital after 3 days with a completed baseline neglect National Institute for Health Stroke Scale (NIHSS) score. Thirty percent had neglect (NIHSS item 11 ≥ 1) and they were slightly older (78 years) than those without neglect (75 years). Neglect was observed more commonly in women (33 vs. 27%) and in individuals with a premorbid dependency (37 vs. 28%). Survivors of mild stroke were far less likely to present with neglect than those with severe stroke (4% vs. 84%). Those with neglect had a greatly increased length of stay (27 vs. 10 days). They received a comparable amount of average daily occupational and physiotherapy during their longer inpatient stay but on discharge a greater percentage of individuals with neglect were dependent on the modified Rankin scale (76 vs. 57%). Spatial neglect is common and associated with worse clinical outcomes. These results add to our understanding of neglect to inform clinical guidelines, service provision and priorities for future research.
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Affiliation(s)
- Ulrike Hammerbeck
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester M13 9PL, UK;
| | - Matthew Gittins
- Centre for Biostatistics, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester M13 9PL, UK; (M.G.); (A.V.)
| | - Andy Vail
- Centre for Biostatistics, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester M13 9PL, UK; (M.G.); (A.V.)
| | - Lizz Paley
- School of Population Health and Environmental Sciences, Kings College London, London SE1 1UL, UK;
| | - Sarah F Tyson
- Division of Nursing, Midwifery and Social Work, University of Manchester, MAHSC, Manchester M13 9PL, UK;
| | - Audrey Bowen
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester M13 9PL, UK;
- Correspondence: ; Tel.:+44-161-275-1235
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34
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Minton T, Hale K. Gloucester’s neurology book club recently took on ‘ Left Neglected’ by Lisa Genova. Pract Neurol 2019; 19:551. [DOI: 10.1136/practneurol-2019-002259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 03/17/2019] [Indexed: 11/03/2022]
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35
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McDonald MW, Black SE, Copland DA, Corbett D, Dijkhuizen RM, Farr TD, Jeffers MS, Kalaria RN, Karayanidis F, Leff AP, Nithianantharajah J, Pendlebury S, Quinn TJ, Clarkson AN, O'Sullivan MJ. Cognition in Stroke Rehabilitation and Recovery Research: Consensus-Based Core Recommendations From the Second Stroke Recovery and Rehabilitation Roundtable. Neurorehabil Neural Repair 2019; 33:943-950. [PMID: 31660787 DOI: 10.1177/1545968319886444] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Cognitive impairment is an important target for rehabilitation as it is common following stroke, is associated with reduced quality of life and interferes with motor and other types of recovery interventions. Cognitive function following stroke was identified as an important, but relatively neglected area during the first Stroke Recovery and Rehabilitation Roundtable (SRRR I), leading to a Cognition Working Group being convened as part of SRRR II. There is currently insufficient evidence to build consensus on specific approaches to cognitive rehabilitation. However, we present recommendations on the integration of cognitive assessments into stroke recovery studies generally and define priorities for ongoing and future research for stroke recovery and rehabilitation. A number of promising interventions are ready to be taken forward to trials to tackle the gap in evidence for cognitive rehabilitation. However, to accelerate progress requires that we coordinate efforts to tackle multiple gaps along the whole translational pathway.
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Affiliation(s)
- Matthew W McDonald
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, Canada
| | - Sandra E Black
- Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, Canada
| | - David A Copland
- University of Queensland Centre for Clinical Research, School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Dale Corbett
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, Canada
| | - Rick M Dijkhuizen
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - Tracy D Farr
- School of Life Science, University of Nottingham, Nottingham, UK
| | - Matthew S Jeffers
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, Canada
| | - Rajesh N Kalaria
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Frini Karayanidis
- Priority Research Centre for Stroke & Brain Injury, The University of Newcastle, Callaghan, Australia
| | - Alexander P Leff
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - Jess Nithianantharajah
- Florey Institute of Neuroscience and Mental Health, Florey Department of Neuroscience, University of Melbourne, Parkville, Australia
| | - Sarah Pendlebury
- Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Andrew N Clarkson
- The Department of Anatomy, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, New Zealand
| | - Michael J O'Sullivan
- University of Queensland Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
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36
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Priftis K, Di Salvo S, Zara D. The importance of time limits in detecting signs of left visual peripersonal neglect: a multiple single-case, pilot study. Neurocase 2019; 25:209-215. [PMID: 31448972 DOI: 10.1080/13554794.2019.1658788] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We developed a new visual search test to assess signs of left visual peripersonal neglect. Five right-hemisphere-damaged patients, 10 healthy controls, and 10 orthopedic controls were administered the test in four conditions: easy task (no distractors)/time-limited (45''), easy task (no distractors)/time-unlimited, difficult task (distractors)/time-limited (45''), difficult task (distractors)/time-unlimited. With respect to controls, most RHDP showed signs of left visual peripersonal neglect in the time-limited condition, but not in the time-unlimited condition, particularly on the difficult task. We suggest that the presence of appropriate time limits, in difficult visual search tasks, could considerably improve the diagnosis of left visual peripersonal neglect.
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Affiliation(s)
| | - Sabrina Di Salvo
- Service of integration for sensory disabled people, Sociocultural Coop. Onlus , Mestre (VE) , Italy
| | - Daniela Zara
- Division of Physical Medicine and Rehabilitation, Villa Salus Hospital , Mestre (VE) , Italy
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37
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Malhotra PA. Impairments of attention in Alzheimer's disease. Curr Opin Psychol 2019; 29:41-48. [PMID: 30496975 DOI: 10.1016/j.copsyc.2018.11.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/23/2018] [Accepted: 11/02/2018] [Indexed: 01/01/2023]
Abstract
Alzheimer's Disease (AD) is characteristically perceived as primarily being a disorder of episodic memory, with prominent attentional impairments more typically being associated with other neurodegenerative conditions, such as Dementia with Lewy Bodies. However, attention is also affected early on in Alzheimer's, particularly in individuals with young onset and atypical syndromes. In addition, some initial symptoms that are apparently due to episodic memory loss may be secondary to failures of attentional processes. This review delineates the various attentional impairments that can be observed in patients with AD, and addresses them through the conceptual framework of attention proposed by Posner and Petersen. It also describes how current knowledge of the development of AD has influenced our understanding of how these deficits arise. Finally, there is a brief summary of the effects of current AD treatments on attentional processes, and how future pharmacological approaches might better target these deficits.
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Affiliation(s)
- Paresh A Malhotra
- Division of Brain Sciences, Imperial College London, United Kingdom.
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38
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McDonald MW, Black SE, Copland DA, Corbett D, Dijkhuizen RM, Farr TD, Jeffers MS, Kalaria RN, Karayanidis F, Leff AP, Nithianantharajah J, Pendlebury S, Quinn TJ, Clarkson AN, O’Sullivan MJ. Cognition in stroke rehabilitation and recovery research: Consensus-based core recommendations from the second Stroke Recovery and Rehabilitation Roundtable. Int J Stroke 2019; 14:774-782. [DOI: 10.1177/1747493019873600] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Cognitive impairment is an important target for rehabilitation as it is common following stroke, is associated with reduced quality of life and interferes with motor and other types of recovery interventions. Cognitive function following stroke was identified as an important, but relatively neglected area during the first Stroke Recovery and Rehabilitation Roundtable (SRRR I), leading to a Cognition Working Group being convened as part of SRRR II. There is currently insufficient evidence to build consensus on specific approaches to cognitive rehabilitation. However, we present recommendations on the integration of cognitive assessments into stroke recovery studies generally and define priorities for ongoing and future research for stroke recovery and rehabilitation. A number of promising interventions are ready to be taken forward to trials to tackle the gap in evidence for cognitive rehabilitation. However, to accelerate progress requires that we coordinate efforts to tackle multiple gaps along the whole translational pathway.
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Affiliation(s)
- Matthew W McDonald
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
- Canadian Partnership for Stroke Recovery, Ottawa, Canada
| | - Sandra E Black
- Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
- Canadian Partnership for Stroke Recovery, Ottawa, Canada
| | - David A Copland
- University of Queensland Centre for Clinical Research, School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Dale Corbett
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
- Canadian Partnership for Stroke Recovery, Ottawa, Canada
| | - Rick M Dijkhuizen
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - Tracy D Farr
- School of Life Science, University of Nottingham, Nottingham, UK
| | - Matthew S Jeffers
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
- Canadian Partnership for Stroke Recovery, Ottawa, Canada
| | - Rajesh N Kalaria
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Frini Karayanidis
- Priority Research Centre for Stroke & Brain Injury, The University of Newcastle, Callaghan, Australia
| | - Alexander P Leff
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - Jess Nithianantharajah
- 0Florey Institute of Neuroscience and Mental Health, Florey Department of Neuroscience, University of Melbourne, Parkville, Australia
| | - Sarah Pendlebury
- 1Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Terence J Quinn
- 2Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Andrew N Clarkson
- 3The Department of Anatomy, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, New Zealand
| | - Michael J O’Sullivan
- 4University of Queensland Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
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Lim S, Radicchi F, van den Heuvel MP, Sporns O. Discordant attributes of structural and functional brain connectivity in a two-layer multiplex network. Sci Rep 2019; 9:2885. [PMID: 30814615 PMCID: PMC6393555 DOI: 10.1038/s41598-019-39243-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 01/14/2019] [Indexed: 11/25/2022] Open
Abstract
Several studies have suggested that functional connectivity (FC) is constrained by the underlying structural connectivity (SC) and mutually correlated. However, not many studies have focused on differences in the network organization of SC and FC, and on how these differences may inform us about their mutual interaction. To explore this issue, we adopt a multi-layer framework, with SC and FC, constructed using Magnetic Resonance Imaging (MRI) data from the Human Connectome Project, forming a two-layer multiplex network. In particular, we examine node strength assortativity within and between the SC and FC layer. We find that, in general, SC is organized assortatively, indicating brain regions are on average connected to other brain regions with similar node strengths. On the other hand, FC shows disassortative mixing. This discrepancy is apparent also among individual resting-state networks within SC and FC. In addition, these patterns show lateralization, with disassortative mixing within FC subnetworks mainly driven from the left hemisphere. We discuss our findings in the context of robustness to structural failure, and we suggest that discordant and lateralized patterns of associativity in SC and FC may provide clues to understand laterality of some neurological dysfunctions and recovery.
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Affiliation(s)
- Sol Lim
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, 47405, USA.
- Brain Mapping Unit, Department of Psychiatry, Cambridge University, Cambridge, CB2 3EB, United Kingdom.
| | - Filippo Radicchi
- Center for Complex Networks and Systems Research, School of Informatics, Computing and Engineering, Indiana University, Bloomington, IN, 47405, USA
| | - Martijn P van den Heuvel
- Connectome Lab, Department of Neuroscience, Section Complex Traits Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU Amsterdam, Amsterdam, 1081 HV, The Netherlands
- Department of Clinical Genetics, UMC Amsterdam, Amsterdam Neuroscience, Amsterdam, 1081 HV, The Netherlands
| | - Olaf Sporns
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, 47405, USA.
- Network Science Institute, Indiana University, Bloomington, IN, 47405, USA.
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Klarendic M, Kojovic M. The Christmas gathering: a household guide to neurological symptoms. How to use the most versatile and common object patients use, a home, in neurological diagnostics. Postgrad Med J 2019; 94:675-677. [PMID: 30700612 DOI: 10.1136/postgradmedj-2018-136272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 12/04/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Maja Klarendic
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Maja Kojovic
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Ohmatsu S, Takamura Y, Fujii S, Tanaka K, Morioka S, Kawashima N. Visual search pattern during free viewing of horizontally flipped images in patients with unilateral spatial neglect. Cortex 2019; 113:83-95. [PMID: 30620921 DOI: 10.1016/j.cortex.2018.11.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 07/12/2018] [Accepted: 11/30/2018] [Indexed: 10/27/2022]
Abstract
Eye tracking is an effective tool for identifying behavioural aspects of unilateral spatial neglect (USN), which is a common neurological syndrome that develops after a right hemisphere lesion. Here, we attempted to elucidate how the neglect symptom affects the symmetry of the gaze pattern, by performing an analysis of gaze distribution during the free viewing of a pair of horizontally flipped images. Based on their Behavioural Inattention Test (BIT) scores, 41 patients with right-hemisphere damage were classified into those with USN (n = 27) and those without USN (right hemisphere damaged - RHD; n = 14). Eye movement was recorded while the patients viewed six pairs of horizontally flipped images on a computer display. A pair of flipped images has both similar and consistent elements, as well as a reversed spatial location of objects (right-left). We calculated the gaze distribution, extent of gaze shift, total gaze distance, and gaze velocity in each direction. Our results demonstrated a significantly larger rightward gaze shift in the USN group, which showed a significant correlation with the BIT score. More importantly, the extent of gaze shift and total gaze distance were similarly modulated by the contents of the displayed images in both the USN and RHD groups. Our findings suggest that analyses of gaze distribution during the free viewing of a pair of horizontally flipped images have the potential to precisely reveal neglect behaviour, and our results provide important implications for rehabilitation.
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Affiliation(s)
- Satoko Ohmatsu
- Graduate School of Health Sciences, Kio University, Nara, Japan; Department of Rehabilitation for the Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Saitama, Japan
| | - Yusaku Takamura
- Graduate School of Health Sciences, Kio University, Nara, Japan; Murata Hospital, Osaka, Japan
| | - Shintaro Fujii
- Graduate School of Health Sciences, Kio University, Nara, Japan; Nishiyamato Rehabilitation Hospital, Nara, Japan
| | - Kohei Tanaka
- Shizuoka Rehabilitation Hospital, Shizuoka, Japan
| | - Shu Morioka
- Graduate School of Health Sciences, Kio University, Nara, Japan; Neurorehabilitation Research Center, Kio University, Nara, Japan
| | - Noritaka Kawashima
- Department of Rehabilitation for the Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Saitama, Japan; Neurorehabilitation Research Center, Kio University, Nara, Japan.
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Barrett A, Abdou A, Caulfield MD. The cingulate cortex and spatial neglect. HANDBOOK OF CLINICAL NEUROLOGY 2019; 166:129-150. [DOI: 10.1016/b978-0-444-64196-0.00009-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Ivanova GE, Bushkova YV, Suvorov AY, Stahovskaya LV, Dzhalagoniya IZ, Varako NA, Kovyazina MS, Bushkov FA. Use of a BCI-Exoskeleton Simulator with Multichannel Biofeedback in a Multidisciplinary Rehabilitation Program in Poststroke Patients. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s11055-018-0673-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sjöholm H, Hägg S, Nyberg L, Rolander B, Kammerlind AS. The Cone Evasion Walk test: Reliability and validity in acute stroke. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2018; 24:e1744. [PMID: 30209845 DOI: 10.1002/pri.1744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/26/2018] [Accepted: 07/27/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To estimate the reliability and validity of the Cone Evasion Walk test (CEW), a new test assessing the ability to evade obstacles, in people with acute stroke. METHODS To estimate the reliability of the CEW, video recordings of 20 people with acute stroke performing the test were assessed by 10 physiotherapists on two occasions, resulting in a total of 400 ratings. Patients performed the CEW (n = 221), functional ambulation classification (FAC; n = 204), Timed Up and Go (TUG; n = 173), TUG cognitive (TUG-cog; n = 139), Serial 7s attention task from the Montreal Cognitive Assessment (MoCA-S7; n = 127), and the Star Cancellation Test (SCT; n = 151). These tests and side of lesion (n = 143) were used to examine construct validity. The predictive validity was evaluated in relation to falls during the following 6 months (n = 203). RESULTS The intraclass correlation coefficients for intrarater and interrater reliability were 0.88-0.98. For validity, there were significant correlations between the CEW and FAC (rs = -0.67), TUG (rs = 0.45), MoCA-S7 (rs = -0.36), and SCT total score (rs = -0.36). There was a significant correlation between the number of cones touched on the left side and the proportion of cancelled stars on the left (rs = -0.23) and right (rs = 0.23) side in the SCT. Among right hemisphere stroke participants (n = 79), significantly more persons hit cones on the left side (n = 25) than the right side (n = 8), whereas among those with a left hemisphere stroke (n = 64) significantly more persons hit cones on the right side (n = 11) than the left (n = 3). Cox regression showed that participants who touched four to eight cones had an increased risk of falls over time (hazard ratio 2.11, 95% CI [1.07, 4.17]) compared with those who touched none. CONCLUSION The new CEW test was reliable and valid in assessing the ability to evade obstacles while walking and to predict falls in patients with acute stroke.
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Affiliation(s)
- Hanna Sjöholm
- Rehabilitation Centre, Region Jönköping County, Jönköping and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Staffan Hägg
- Futurum, Region Jönköping County, Jönköping and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Lars Nyberg
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Bo Rolander
- Futurum, Region Jönköping County, Jönköping, Sweden
| | - Ann-Sofi Kammerlind
- Futurum, Region Jönköping County, Jönköping and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Hegdé J. Neural Mechanisms of High-Level Vision. Compr Physiol 2018; 8:903-953. [PMID: 29978891 DOI: 10.1002/cphy.c160035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The last three decades have seen major strides in our understanding of neural mechanisms of high-level vision, or visual cognition of the world around us. Vision has also served as a model system for the study of brain function. Several broad insights, as yet incomplete, have recently emerged. First, visual perception is best understood not as an end unto itself, but as a sensory process that subserves the animal's behavioral goal at hand. Visual perception is likely to be simply a side effect that reflects the readout of visual information processing that leads to behavior. Second, the brain is essentially a probabilistic computational system that produces behaviors by collectively evaluating, not necessarily consciously or always optimally, the available information about the outside world received from the senses, the behavioral goals, prior knowledge about the world, and possible risks and benefits of a given behavior. Vision plays a prominent role in the overall functioning of the brain providing the lion's share of information about the outside world. Third, the visual system does not function in isolation, but rather interacts actively and reciprocally with other brain systems, including other sensory faculties. Finally, various regions of the visual system process information not in a strict hierarchical manner, but as parts of various dynamic brain-wide networks, collectively referred to as the "connectome." Thus, a full understanding of vision will ultimately entail understanding, in granular, quantitative detail, various aspects of dynamic brain networks that use visual sensory information to produce behavior under real-world conditions. © 2017 American Physiological Society. Compr Physiol 8:903-953, 2018.
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Affiliation(s)
- Jay Hegdé
- Brain and Behavior Discovery Institute, Augusta University, Augusta, Georgia, USA.,James and Jean Culver Vision Discovery Institute, Augusta University, Augusta, Georgia, USA.,Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA.,The Graduate School, Augusta University, Augusta, Georgia, USA
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EEG-based neglect assessment: A feasibility study. J Neurosci Methods 2018; 303:169-177. [PMID: 29614297 DOI: 10.1016/j.jneumeth.2018.03.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/30/2018] [Accepted: 03/30/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Spatial neglect (SN) is a neuropsychological syndrome that impairs automatic attention orienting to stimuli in the contralesional visual space of stroke patients. SN is commonly assessed using paper and pencil tests. Recently, computerized tests have been proposed to provide a dynamic assessment of SN. However, both paper- and computer-based methods have limitations. NEW METHOD Electroencephalography (EEG) shows promise for overcoming the limitations of current assessment methods. The aim of this work is to introduce an objective passive BCI system that records EEG signals in response to visual stimuli appearing in random locations on a screen with a dynamically changing background. Our preliminary experimental studies focused on validating the system using healthy participants with intact brains rather than employing it initially in more complex environments with patients having cortical lesions. Therefore, we designed a version of the test in which we simulated SN by hiding target stimuli appearing on the left side of the screen so that the subject's attention is shifted to the right side. RESULTS Results showed that there are statistically significant differences between EEG responses due to right and left side stimuli reflecting different processing and attention levels towards both sides of the screen. The system achieved average accuracy, sensitivity and specificity of 74.24%, 75.17% and 71.36% respectively. COMPARISON WITH EXISTING METHODS The proposed test can examine both presence and severity of SN, unlike traditional paper and pencil tests and computer-based methods. CONCLUSIONS The proposed test is a promising objective SN evaluation method.
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Extinction as a deficit of the decision-making circuitry in the posterior parietal cortex. HANDBOOK OF CLINICAL NEUROLOGY 2018. [PMID: 29519457 DOI: 10.1016/b978-0-444-63622-5.00008-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
Extinction is a common neurologic deficit that often occurs as one of a constellation of symptoms seen with lesions of the posterior parietal cortex (PPC). Although extinction has typically been considered a deficit in the allocation of attention, new findings, particularly from nonhuman primate studies, point to one potential and important source of extinction as damage to decision-making circuits for actions within the PPC. This new understanding provides clues to potential therapies for extinction. Also the finding that the PPC is important for action decisions and action planning has led to new neuroprosthetic applications using PPC recordings as control signals to assist paralyzed patients.
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Zeller D, Hullin M. Spatial attention and the malleability of bodily self in the elderly. Conscious Cogn 2018; 59:32-39. [DOI: 10.1016/j.concog.2018.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 01/17/2018] [Accepted: 01/25/2018] [Indexed: 01/31/2023]
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Orjuela-Rojas JM, Sosa-Ortiz AL, Díaz-Victoria AR, Marrufo Melendez OR, Leyva Townsend N. The painter from Sinaloa: artistic analysis of a case of spatial agnosia and neglect of visual shapes. Neurocase 2017; 23:304-313. [PMID: 29185377 DOI: 10.1080/13554794.2017.1408842] [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: 10/18/2022]
Abstract
Paintings produced spontaneously by patients with neurological lesions represent a fascinating opportunity to analyze some aspects of the underlying disease and involved brain mechanisms. Many cases of artists who have suffered spatial neglect following a neurological disease have been reported in the literature. However, only a few studies evaluating the different subtypes of graphic neglect and aspects related to the construction of perspective (three dimensionality) in works of art have been published. In the present article, we present the case of an artist who, after resection of a central neurocytoma that affected the right thalamo-parietal connections, suffered an impairment of the ability to create perspective in his paintings and involuntary omission of only shapes in the left side of his paintings, although colors and contours were preserved.
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Affiliation(s)
| | - Ana Luisa Sosa-Ortiz
- b Laboratory of Dementias , National Institute of Neurology and Neurosurgery , Mexico City , Mexico
| | - Ana Ruth Díaz-Victoria
- c Cognitive and Behavior Unit , National Institute of Neurology and Neurosurgery , Mexico City , Mexico
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De Luca R, Lo Buono V, Leo A, Russo M, Aragona B, Leonardi S, Buda A, Naro A, Calabrò RS. Use of virtual reality in improving poststroke neglect: Promising neuropsychological and neurophysiological findings from a case study. APPLIED NEUROPSYCHOLOGY-ADULT 2017; 26:96-100. [PMID: 28937807 DOI: 10.1080/23279095.2017.1363040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
After experiencing a stroke in the right hemisphere, almost 50% of patients show unilateral spatial neglect (USN). Virtual Reality technologies offer impressive opportunities for both the rehabilitation and assessment of different cognitive deficits, including USN. A 57-year-old woman, affected by subarachnoid hemorrhage presented a severe left hemiparesis with severe cognitive and behavioral alterations, including temporal and spatial disorientation, reduction of attention and memory process, slowing ideation, USN, and depression of mood. She underwent two different rehabilitation trainings, including standard cognitive training (SCT) in addition to semi-immersive virtual training with her shadow (S-IVT_s) and SCT in addition to a Semi- immersive virtual training, without her shadow (S-IVT). The patient was assessed before and after each of the two different trainings, by using a specific psychometric battery and the event related potential, P300. Only at the end of the use of the S-IVT, we observed a significant improvement in the motor and cognitive function, with regard to USN. SCT in addition to S-IVT with Bts-Nirvana System may be a promising approach in improving attention process, spatial cognition, and mood in patients with post stroke USN, as also demonstrated by the electrophysiological parameters.
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Affiliation(s)
- Rosaria De Luca
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Viviana Lo Buono
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Antonino Leo
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Margherita Russo
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Bianca Aragona
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Simona Leonardi
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Antonio Buda
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
| | - Antonino Naro
- a IRCCS Centro Neurolesi "Bonino Pulejo" Messina , Messina , Italy
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