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Bufacchi RJ, Battaglia-Mayer A, Iannetti GD, Caminiti R. Cortico-spinal modularity in the parieto-frontal system: A new perspective on action control. Prog Neurobiol 2023; 231:102537. [PMID: 37832714 DOI: 10.1016/j.pneurobio.2023.102537] [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: 04/02/2023] [Revised: 08/22/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023]
Abstract
Classical neurophysiology suggests that the motor cortex (MI) has a unique role in action control. In contrast, this review presents evidence for multiple parieto-frontal spinal command modules that can bypass MI. Five observations support this modular perspective: (i) the statistics of cortical connectivity demonstrate functionally-related clusters of cortical areas, defining functional modules in the premotor, cingulate, and parietal cortices; (ii) different corticospinal pathways originate from the above areas, each with a distinct range of conduction velocities; (iii) the activation time of each module varies depending on task, and different modules can be activated simultaneously; (iv) a modular architecture with direct motor output is faster and less metabolically expensive than an architecture that relies on MI, given the slow connections between MI and other cortical areas; (v) lesions of the areas composing parieto-frontal modules have different effects from lesions of MI. Here we provide examples of six cortico-spinal modules and functions they subserve: module 1) arm reaching, tool use and object construction; module 2) spatial navigation and locomotion; module 3) grasping and observation of hand and mouth actions; module 4) action initiation, motor sequences, time encoding; module 5) conditional motor association and learning, action plan switching and action inhibition; module 6) planning defensive actions. These modules can serve as a library of tools to be recombined when faced with novel tasks, and MI might serve as a recombinatory hub. In conclusion, the availability of locally-stored information and multiple outflow paths supports the physiological plausibility of the proposed modular perspective.
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Affiliation(s)
- R J Bufacchi
- Neuroscience and Behaviour Laboratory, Istituto Italiano di Tecnologia, Rome, Italy; International Center for Primate Brain Research (ICPBR), Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences (CAS), Shanghai, China
| | - A Battaglia-Mayer
- Department of Physiology and Pharmacology, University of Rome, Sapienza, Italy
| | - G D Iannetti
- Neuroscience and Behaviour Laboratory, Istituto Italiano di Tecnologia, Rome, Italy; Department of Neuroscience, Physiology and Pharmacology, University College London (UCL), London, UK
| | - R Caminiti
- Neuroscience and Behaviour Laboratory, Istituto Italiano di Tecnologia, Rome, Italy.
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2
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Kusec A, Milosevich E, Williams OA, Chiu EG, Watson P, Carrick C, Drozdowska BA, Dillon A, Jennings T, Anderson B, Dawes H, Thomas S, Kuppuswamy A, Pendlebury ST, Quinn TJ, Demeyere N. Long-term psychological outcomes following stroke: the OX-CHRONIC study. BMC Neurol 2023; 23:426. [PMID: 38036966 PMCID: PMC10688008 DOI: 10.1186/s12883-023-03463-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/10/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Stroke survivors rate longer-term (> 2 years) psychological recovery as their top priority, but data on how frequently psychological consequences occur is lacking. Prevalence of cognitive impairment, depression/anxiety, fatigue, apathy and related psychological outcomes, and whether rates are stable in long-term stroke, is unknown. METHODS N = 105 long-term stroke survivors (M [SD] age = 72.92 [13.01]; M [SD] acute NIH Stroke Severity Score = 7.39 [6.25]; 59.0% Male; M [SD] years post-stroke = 4.57 [2.12]) were recruited (potential N = 208). Participants completed 3 remote assessments, including a comprehensive set of standardized cognitive neuropsychological tests comprising domains of memory, attention, language, and executive function, and questionnaires on emotional distress, fatigue, apathy and other psychological outcomes. Ninety participants were re-assessed one year later. Stability of outcomes was assessed by Cohen's d effect size estimates and percent Minimal Clinically Important Difference changes between time points. RESULTS On the Montreal Cognitive Assessment 65.3% scored < 26. On the Oxford Cognitive Screen 45.9% had at least one cognitive impairment. Attention (27.1%) and executive function (40%) were most frequently impaired. 23.5% and 22.5% had elevated depression/anxiety respectively. Fatigue (51.4%) and apathy (40.5%) rates remained high, comparable to estimates in the first-year post-stroke. Attention (d = -0.12; 85.8% stable) and depression (d = 0.09, 77.1% stable) were the most stable outcomes. Following alpha-adjustments, only perceptuomotor abilities (d = 0.69; 40.4% decline) and fatigue (d = -0.33; 45.3% decline) worsened over one year. Cognitive impairment, depression/anxiety, fatigue and apathy all correlated with worse quality of life. CONCLUSION Nearly half of participants > 2 years post-event exhibited psychological difficulties including domains of cognition, mood, and fatigue, which impact long-term quality of life. Stroke is a chronic condition with highly prevalent psychological needs, which require monitoring and intervention development.
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Affiliation(s)
- Andrea Kusec
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, UK
| | - Elise Milosevich
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, UK
| | - Owen A Williams
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, UK
| | - Evangeline G Chiu
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, UK
| | - Pippa Watson
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, UK
| | - Chloe Carrick
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, UK
| | - Bogna A Drozdowska
- School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
| | - Avril Dillon
- Department of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | | | - Bloo Anderson
- Patient and Public Involvement Representative, Oxford, UK
| | - Helen Dawes
- NIHR Exeter Biomedical Research Centre, University of Exeter, Medical School Building, St Luke's Campus, Magdalen Road, Exeter, UK
| | - Shirley Thomas
- School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Annapoorna Kuppuswamy
- Institute of Neurology Department of Clinical and Movement Neurosciences, University College London, 33 Queen Square, London, UK
- Department of Biomedical Sciences, University of Leeds, Leeds, UK
| | - Sarah T Pendlebury
- Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Terence J Quinn
- School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
| | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, UK.
- Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK.
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3
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De Lucia N, Ragno M, Paci C, Cacchiò G, Caiazzo AR, Tiberi S, De Rosa A, Navarra R, Caulo M, De Michele G, Trojano L. Constructional Impairments and Their Neural Correlates in Nondemented Adults With Cerebral Autosomal-dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy. Cogn Behav Neurol 2022; 35:247-254. [PMID: 36149396 DOI: 10.1097/wnn.0000000000000318] [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: 09/20/2021] [Accepted: 03/02/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic small-vessel disease that is characterized by a wide range of neurologic and neuropsychological impairments. Constructional impairments have been reported in some cases but have never been assessed systematically. OBJECTIVE To evaluate constructional abilities and their cognitive and neural correlates in nondemented individuals with CADASIL. METHOD Thirty individuals with CADASIL who were not affected by clinically relevant cognitive deterioration and 30 healthy controls (HC) underwent an extensive cognitive assessment and paper-and-pencil visuoconstructional tasks in order to detect constructional impairments. Performance on the visuoconstructional tasks was correlated with the cognitive assessment scores and with quantitative indices of regional gray matter atrophy (obtained via FreeSurfer image analysis) and white matter involvement. RESULTS The individuals with CADASIL achieved significantly lower scores on the cognitive assessment compared with the HC. Poor visuoconstructional abilities were observed in seven (23.3%) of the individuals with CADASIL when performing the copy drawing task and in nine (30%) when performing the Rey Complex Figure Test. Logistic regression revealed that visuoconstructional impairments were significantly associated with scores on the Frontal Assessment Battery and the Attentional Matrices Test. Morphometric results revealed that scores on the visuoconstructional tasks were related to gray matter atrophy of the left frontal lobe and right parietal lobe. CONCLUSION Impairments on visuoconstructional tasks are quite common in individuals with CADASIL, even in the lack of clinically relevant cognitive deterioration, and are critically related to frontal and parietal atrophy.
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Affiliation(s)
- Natascia De Lucia
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico," Naples, Italy
| | - Michele Ragno
- Neurology Division, San Benedetto del Tronto, Ascoli Piceno, Italy
| | - Cristina Paci
- Neurology Division, San Benedetto del Tronto, Ascoli Piceno, Italy
| | | | | | - Sara Tiberi
- Neurology Division, San Benedetto del Tronto, Ascoli Piceno, Italy
| | - Anna De Rosa
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico," Naples, Italy
| | - Riccardo Navarra
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies, "D'Annunzio" University of Chiety-Pescara, Chieti, Italy
| | - Massimo Caulo
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies, "D'Annunzio" University of Chiety-Pescara, Chieti, Italy
| | - Giuseppe De Michele
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico," Naples, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
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4
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Moore M, Milosevich E, Beisteiner R, Bowen A, Checketts M, Demeyere N, Fordell H, Godefroy O, Laczó J, Rich T, Williams L, Woodward-Nutt K, Husain M. Rapid screening for neglect following stroke: A systematic search and European Academy of Neurology recommendations. Eur J Neurol 2022; 29:2596-2606. [PMID: 35510782 PMCID: PMC9544365 DOI: 10.1111/ene.15381] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Abstract
Background and purpose Unilateral neglect is a common cognitive disorder following stroke. Neglect has a significant impact on functional outcomes, so it is important to detect. However, there is no consensus on which are the best screening tests to administer to detect neglect in time‐limited clinical environments. Methods Members of the European Academy of Neurology Scientific Panel on Higher Cortical Functions, neuropsychologists, occupational therapists, and researchers produced recommendations for primary and secondary tests for bedside neglect testing based on a rigorous literature review, data extraction, online consensus meeting, and subsequent iterations. Results A total of 512 articles were screened, and 42 were included. These reported data from 3367 stroke survivors assessed using 62 neglect screens. Tests were grouped into cancellation, line bisection, copying, reading/writing, and behavioral. Cancellation tasks were most frequently used (97.6% of studies), followed by bisection, copying, behavioral, and reading/writing assessments. The panel recommended a cancellation test as the primary screening test if there is time to administer only one test. One of several cancellation tests might be used, depending on availability. If time permits, one or more of line bisection, figure copying, and baking tray task were recommended as secondary tests. Finally, if a functional and ecological test is feasible, the Catherine Bergego Scale was recommended. Overall, the literature suggests that no single test on its own is sufficient to exclude a diagnosis of neglect. Therefore, the panel recommended that multiple neglect tests should be used whenever possible. Conclusions This study provides consensus recommendations for rapid bedside detection of neglect in real‐world, clinical environments.
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Affiliation(s)
- Margaret Moore
- Dept Experimental Psychology, University of Oxford, Oxford, UK.,Queensland Brain Institute, University of Brisbane, Brisbane, Australia
| | | | | | - Audrey Bowen
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Matthew Checketts
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, MAHSC, UK
| | - Nele Demeyere
- Dept Experimental Psychology, University of Oxford, Oxford, UK
| | | | - Olivier Godefroy
- Department of Neurology and Laboratoire de Neurosciences Fonctionnelles et Pathologies, Amiens University Medical Center, Jules Verne University of Picardy, Amiens, France
| | - Jan Laczó
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Timothy Rich
- Kessler Foundation, West Orange, New Jersey, USA & Rutgers University, Physical Medicine and Rehabilitation, Newark, New Jersey, USA
| | - Lindy Williams
- Cognitive Aging and Impairment Neurosciences Lab, University of South Australia, Adelaide, Australia
| | - Kate Woodward-Nutt
- Research and Innovation, Northern Care Alliance NHS Group, Salford, United Kingdom
| | - Masud Husain
- Dept Experimental Psychology, University of Oxford, Oxford, UK.,Nuffield Dept Clinical Neurosciences, University of Oxford, Oxford, UK
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5
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Distinct roles of right temporoparietal cortex in pentagon copying test. Brain Imaging Behav 2022; 16:1528-1537. [PMID: 35083712 DOI: 10.1007/s11682-021-00607-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 11/02/2022]
Abstract
Pentagon Copying Test (PCT) is commonly used to assess visuospatial deficits, but the neural substrates underlying pentagon copying are not well understood. The Qualitative Scoring Pentagon Test (QSPT), an optimized scoring system, classifies five categories of errors patients make in pentagons copying and grades them depending on the errors' severity. To determine the strategic brain regions involved in the PCT, we applied the QSPT system to evaluate the visuospatial impairment of 136 acute ischemic stroke patients on the PCT and used Support Vector Regression Lesion-Symptom Mapping to investigate relevant brain regions. The total QSPT score was correlated with the right supramarginal gyrus. The angle number errors and closure errors were principally associated with lesions of the posterior temporoparietal cortex, including the right middle occipital gyrus and middle temporal gyrus, while the intersection errors and rotation errors were related to the more anterior part of the right temporoparietal lobe with the additional frontal cortex. In conclusion, the right temporoparietal cortex is the strategic region for pentagon copying tasks. The angle number and closure represent the visuospatial processing of within-object features, while intersection and rotation require between-object manipulation. The posterior-anterior distinction in the right temporoparietal region underlies the differences of within-object and between-object processing.
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Nagahama Y, Okina T, Suzuki N. Neuropsychological basis of impaired gesture imitations in patients with Alzheimer's disease and dementia with Lewy bodies. Int J Geriatr Psychiatry 2022; 37. [PMID: 34505307 DOI: 10.1002/gps.5622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 09/06/2021] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The aim of this study was to examine the neuropsychological factors that may be related to the impaired gesture imitations in patients with dementia. METHODS The imitation of unilateral finger and bimanual gestures was evaluated in 162 patients with Alzheimer's disease (AD) and 103 patients with dementia with Lewy bodies (DLB). The relationships of gesture imitation performance to global cognition, semantic fluency, phonemic fluency, figure copying, clock drawing, and trail-making test part A (TMT-A) scores were examined. RESULTS Mean scores for unilateral finger imitation were significantly lower in DLB patients than in AD patients, and significantly more DLB patients showed impaired performance in unilateral finger imitation than AD patients. In contrast, the percentage of patients with impaired bimanual gesture imitation was not significantly different between AD and DLB patients. Unilateral finger imitation performance was predicted by pentagon copying in the AD patients, and was predicted by cube copying in the DLB patients. Bimanual gesture imitation performance was predicted by TMT-A scores and phonemic fluency in the AD patients but was predicted by TMT-A scores, cube copying, and parkinsonism severity in the DLB patients. DISCUSSION Our study suggested that bimanual gesture imitation is a complex task that is supported by a wide range of neuropsychological processes, such as visuospatial attention, executive function, and visuomotor control, and therefore, it was easily impaired in early dementia. Unilateral finger imitation was more similar to constructional tasks, such as figure drawing, and was impaired more often in DLB patients than in AD patients.
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Affiliation(s)
- Yasuhiro Nagahama
- Department of Psychiatry and Neurology, Kawasaki Memorial Hospital, Kawasaki, Kanagawa, Japan
| | - Tomoko Okina
- Department of Geriatric Neurology, Shiga General Hospital, Moriyama, Shiga, Japan
| | - Norio Suzuki
- Department of Geriatric Neurology, Shiga General Hospital, Moriyama, Shiga, Japan
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Bai S, Liu W, Guan Y. The Visuospatial and Sensorimotor Functions of Posterior Parietal Cortex in Drawing Tasks: A Review. Front Aging Neurosci 2021; 13:717002. [PMID: 34720989 PMCID: PMC8551751 DOI: 10.3389/fnagi.2021.717002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/23/2021] [Indexed: 02/04/2023] Open
Abstract
Drawing is a comprehensive skill that primarily involves visuospatial processing, eye-hand coordination, and other higher-order cognitive functions. Various drawing tasks are widely used to assess brain function. The neuropsychological basis of drawing is extremely sophisticated. Previous work has addressed the critical role of the posterior parietal cortex (PPC) in drawing, but the specific functions of the PPC in drawing remain unclear. Functional magnetic resonance imaging and electrophysiological studies found that drawing activates the PPC. Lesion-symptom mapping studies have shown an association between PPC injury and drawing deficits in patients with global and focal cerebral pathology. These findings depicted a core framework of the fronto-parietal network in drawing tasks. Here, we review neuroimaging and electrophysiological studies applying drawing paradigms and discuss the specific functions of the PPC in visuospatial and sensorimotor aspects. Ultimately, we proposed a hypothetical model based on the dorsal stream. It demonstrates the organization of a PPC-centered network for drawing and provides systematic insights into drawing for future neuropsychological research.
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Affiliation(s)
- Shuwei Bai
- Department of Neurology, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Department of Neurology, Renji Hospital, Shanghai Jiaotong University Medical School, Shanghai, China
| | - Wenyan Liu
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University Medical School, Shanghai, China
| | - Yangtai Guan
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University Medical School, Shanghai, China
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8
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The Neural Bases of Drawing. A Meta-analysis and a Systematic Literature Review of Neurofunctional Studies in Healthy Individuals. Neuropsychol Rev 2021; 31:689-702. [PMID: 33728526 PMCID: PMC8593049 DOI: 10.1007/s11065-021-09494-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 03/01/2021] [Indexed: 12/13/2022]
Abstract
Drawing is a multi-component process requiring a wide range of cognitive abilities. Several studies on patients with focal brain lesions and functional neuroimaging studies on healthy individuals demonstrated that drawing is associated with a wide brain network. However, the neural structures specifically related to drawing remain to be better comprehended. We conducted a systematic review complemented by a meta-analytic approach to identify the core neural underpinnings related to drawing in healthy individuals. In analysing the selected studies, we took into account the type of the control task employed (i.e. motor or non-motor) and the type of drawn stimulus (i.e. geometric, figurative, or nonsense). The results showed that a fronto-parietal network, particularly on the left side of the brain, was involved in drawing when compared with other motor activities. Drawing figurative images additionally activated the inferior frontal gyrus and the inferior temporal cortex, brain areas involved in selection of semantic features of objects and in visual semantic processing. Moreover, copying more than drawing from memory was associated with the activation of extrastriate cortex (BA 18, 19). The activation likelihood estimation coordinate-based meta-analysis revealed a core neural network specifically associated with drawing which included the premotor area (BA 6) and the inferior parietal lobe (BA 40) bilaterally, and the left precuneus (BA 7). These results showed that a fronto-parietal network is specifically involved in drawing and suggested that a crucial role is played by the (left) inferior parietal lobe, consistent with classical literature on constructional apraxia.
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Robens S, Heymann P, Gienger R, Hett A, Müller S, Laske C, Loy R, Ostermann T, Elbing U. The Digital Tree Drawing Test for Screening of Early Dementia: An Explorative Study Comparing Healthy Controls, Patients with Mild Cognitive Impairment, and Patients with Early Dementia of the Alzheimer Type. J Alzheimers Dis 2020; 68:1561-1574. [PMID: 30909229 DOI: 10.3233/jad-181029] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The digital tree drawing test (dTDT) is a newly developed screening tool for the early detection of Alzheimer's disease. It is performed with a digitizing pen, recording each pen stroke with temporal and spatial precision. It was hypothesized that movement characteristics recorded during the painting process contribute to the identification of patients with mild cognitive impairment (MCI) and early dementia of the Alzheimer type (eDAT). The study population consisted of 187 participants (67 healthy controls, 64 MCI, and 56 eDAT patients) with a mean age of 68.6±10.6 years. Between-group comparisons of the dTDT-variables were conducted with analysis of variance. The diagnostic power of dTDT variables was analyzed with stepwise logistic regressions and areas under curve (AUC) of receiver operating control curves. Cognitively impaired persons used less colors and line widths and changed them less often than healthy subjects (p-values ≤0.05). Compared to control, eDAT patients had larger not-painting periods, were slower, and their pictures had less contrast, image size, and complexity (p-values ≤0.01). Logistic regression models of stepwise selected dTDT variables resulted in an AUC of 0.84 (95% confidence interval (CI) [0.79, 0.90], sensitivity = 0.78, specificity = 0.77) for discriminating healthy subjects from all cognitive impaired, an AUC of 0.77. (95% CI [0.69; 0.85], sensitivity = 0.56, specificity = 0.83) for discriminating healthy controls from MCI patients and an AUC of 0.90 (95% CI [0.84, 0.96], sensitivity = 0.86, specificity = 0.82) for discriminating controls from eDAT patients. The results suggest that digital recording of pen-stroke data during the drawing process can contribute to the screening of cognitive impaired patients.
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Affiliation(s)
- Sibylle Robens
- Department of Psychology and Psychotherapy, University Witten/Herdecke, Witten, Germany
| | - Petra Heymann
- Nürtingen-Geislingen University (HfWU), Institute of Research and Development in Art Therapies, Nürtingen, Germany
| | - Regine Gienger
- Nürtingen-Geislingen University (HfWU), Institute of Research and Development in Art Therapies, Nürtingen, Germany
| | - Andreas Hett
- Nürtingen-Geislingen University (HfWU), Institute of Research and Development in Art Therapies, Nürtingen, Germany
| | - Stephan Müller
- Department of Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany
| | | | - Thomas Ostermann
- Department of Psychology and Psychotherapy, University Witten/Herdecke, Witten, Germany
| | - Ulrich Elbing
- Nürtingen-Geislingen University (HfWU), Institute of Research and Development in Art Therapies, Nürtingen, Germany
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10
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Kobinata N, Yoshikawa H, Iwasaka Y, Kawate N. Lowered Rhythm Tapping Ability in Patients With Constructional Apraxia After Stroke. Front Neurosci 2020; 14:247. [PMID: 32265645 PMCID: PMC7105890 DOI: 10.3389/fnins.2020.00247] [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: 07/25/2019] [Accepted: 03/04/2020] [Indexed: 12/02/2022] Open
Abstract
Rhythm tapping tasks are often used to explore temporal reproduction abilities. Many studies utilizing rhythm tapping tasks are conducted to evaluate temporal processing abilities with neurological impairments and neurodegenerative disorders. Among sensorimotor and cognitive disorders, rhythm processing abilities in constructional apraxia, a deficit in achieving visuospatial constructional activities, has not been evaluated. This study aimed to examine the rhythm tapping ability of patients with constructional apraxia after a stroke. Twenty-four patients were divided into two groups: with and without constructional apraxia. There were 11 participants in the constructional apraxia group and 13 in the without constructional apraxia group. The synchronization-continuation paradigm was employed in which a person performs a synchronized tapping activity to a metronome beat and continues tapping after the beat has stopped. For statistical analysis, a three-way mixed analysis of variance (2 × 2 × 3) was conducted. The factors were groups (with and without constructional apraxia), tapping tasks (synchronization and continuation), and inter-stimulus intervals (600, 750, and 1000 ms). A significant effect of group factor was found (F[1,132] = 16.62; p < 0.001). Patients in the without constructional apraxia group were able to more accurately reproduce intervals than those in the constructional apraxia group. Moreover, a significant effect of tapping tasks was found (F[1,132] = 8.22; p < 0.01). Intervals were reproduced more accurately for synchronization tasks than continuation tasks. There was no significant inter-stimulus interval effect. Overall, these results suggest that there might be a relation between temporal and spatial reproductions in a wide spectrum of processing levels, from sensory perception to cognitive function.
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Affiliation(s)
- Naomi Kobinata
- Department of Rehabilitation Medicine, School of Medicine, Showa University, Tokyo, Japan.,Department of Rehabilitation, Yoshieikai Hospital, Osaka, Japan
| | | | - Yuji Iwasaka
- Department of Physical Therapy, Nihon Institute of Medical Science, Saitama, Japan
| | - Nobuyuki Kawate
- Department of Rehabilitation Medicine, School of Medicine, Showa University, Tokyo, Japan
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11
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Chen H, Pan X, Bickerton WL, Lau JK, Zhou J, Zhou B, Harris L, Rotshtein P. Delineating the cognitive-neural substrates of writing: a large scale behavioral and voxel based morphometry study. Sci Rep 2019; 9:18881. [PMID: 31827143 PMCID: PMC6906401 DOI: 10.1038/s41598-019-55129-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 11/23/2019] [Indexed: 11/26/2022] Open
Abstract
The current study investigated the cognitive and neural substrates that underpin writing ability. We explored similarities and differences in writing numbers and words and compared these to language and manual actions in a large group of sub-acute, stroke patients (n = 740). The behavioral data showed association and dissociation in the ability to write words and numbers. Comorbidities of writing deficits with both language and motor impairments were prevalent, with less than a handful showing deficits restricted to the writing tasks. A second analysis with a subset of patients (n = 267) explored the neural networks that mediate writing abilities. Lesion to right temporal contributed to writing words, while lesions to left postcentral contributed to writing numbers. Overlapping neural mechanisms included the bilateral prefrontal cortex, right inferior parietal, left middle occipital and the right cerebellum. With the former regions associated with error pattern typical to writing based on prior knowledge (the lexical route), while lesion to left MOG was associated with errors to the phonological (non-lexical) route. Using principle components extracted from the behavioral data, we showed that right prefrontal and right parietal contributed to the ability to use pen, while lesion to bilateral prefrontal, inferior temporal and cerebellum supported unique use of pen for writing. The behavioral and imaging data suggested that writing numbers and words primarily relied on overlapping cognitive and neural functions. Incidents of pure writing deficits, in the absence of motor or language deficits were rare. Nevertheless, the PCA and neural data suggested that writing abilities were associated with some unique neuro-cognitive functions, specifically dedicated to the use of pen and the ability to transform meaning to motor command.
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Affiliation(s)
- Haobo Chen
- Department of Neurology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, 510000, P.R. China. .,School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Xiaoping Pan
- Department of Neurology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, 510000, P.R. China.
| | | | - Johnny King Lau
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.,School of Psychology and Clinical Language Sciences, University of Reading, Harry Pitt Building, Reading, RG6 7BE, UK
| | - Jin Zhou
- Department of Neurology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, 510000, P.R. China
| | - Beinan Zhou
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.,Faculty of linguistics, philology and phonetics, University of Oxford, Oxford, OX1 3UD, UK
| | - Lara Harris
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.,Department of Psychological Medicine, King's College London, London, WC2R 2LS, UK
| | - Pia Rotshtein
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
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12
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Loughrey DG, Parra MA, Lawlor BA. Visual short-term memory binding deficit with age-related hearing loss in cognitively normal older adults. Sci Rep 2019; 9:12600. [PMID: 31467387 PMCID: PMC6715732 DOI: 10.1038/s41598-019-49023-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 08/19/2019] [Indexed: 01/12/2023] Open
Abstract
Age-related hearing loss (ARHL) has been posited as a possible modifiable risk factor for neurocognitive impairment and dementia. Measures sensitive to early neurocognitive changes associated with ARHL would help to elucidate the mechanisms underpinning this relationship. We hypothesized that ARHL might be associated with decline in visual short-term memory binding (VSTMB), a potential biomarker for preclinical dementia due to Alzheimer’s disease (AD). We examined differences in accuracy between older adults with hearing loss and a control group on the VSTMB task from a single feature (shapes) condition to a feature binding (shapes-colors) condition. Hearing loss was associated with a weaker capacity to process bound features which appeared to be accounted for by a weaker sensitivity for change detection (A’). Our findings give insight into the neural mechanisms underpinning neurocognitive decline with ARHL and its temporal sequence.
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Affiliation(s)
- David G Loughrey
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland/University of California, San Francisco, USA. .,Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
| | - Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.,Programa de Psicología, Universidad Autónoma del Caribe, Barranquilla, Colombia
| | - Brian A Lawlor
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland/University of California, San Francisco, USA.,Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing, St James Hospital, Dublin, Ireland
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13
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Wiesen D, Sperber C, Yourganov G, Rorden C, Karnath HO. Using machine learning-based lesion behavior mapping to identify anatomical networks of cognitive dysfunction: Spatial neglect and attention. Neuroimage 2019; 201:116000. [PMID: 31295567 DOI: 10.1016/j.neuroimage.2019.07.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 12/12/2022] Open
Abstract
Previous lesion behavior studies primarily used univariate lesion behavior mapping techniques to map the anatomical basis of spatial neglect after right brain damage. These studies led to inconsistent results and lively controversies. Given these inconsistencies, the idea of a wide-spread network that might underlie spatial orientation and neglect has been pushed forward. In such case, univariate lesion behavior mapping methods might have been inherently limited in detecting the presumed network due to limited statistical power. By comparing various univariate analyses with multivariate lesion-mapping based on support vector regression, we aimed to validate the network hypothesis directly in a large sample of 203 newly recruited right brain damaged patients. If the exact same correction factors and parameter combinations (FDR correction and dTLVC for lesion size control) were used, both univariate as well as multivariate approaches uncovered the same complex network pattern underlying spatial neglect. At the cortical level, lesion location dominantly affected the temporal cortex and its borders into inferior parietal and occipital cortices. Beyond, frontal and subcortical gray matter regions as well as white matter tracts connecting these regions were affected. Our findings underline the importance of a right network in spatial exploration and attention and specifically in the emergence of the core symptoms of spatial neglect.
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Affiliation(s)
- Daniel Wiesen
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, 72076, Germany
| | - Christoph Sperber
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, 72076, Germany
| | - Grigori Yourganov
- Department of Psychology, University of South Carolina, Columbia, 29208, USA
| | - Christopher Rorden
- Department of Psychology, University of South Carolina, Columbia, 29208, USA
| | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, 72076, Germany; Department of Psychology, University of South Carolina, Columbia, 29208, USA.
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14
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Leem MJ, Moon HI, Yoon SY, Lee HJ, Nam JS. Lesions Responsible for Impaired Visual Perception in Poststroke Patients Using Voxel-Based Lesion Symptom Mapping. Clin Anat 2019; 32:689-696. [PMID: 30873643 DOI: 10.1002/ca.23373] [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: 01/01/2019] [Revised: 03/04/2019] [Accepted: 03/13/2019] [Indexed: 11/11/2022]
Abstract
We aimed to clarify the clinical characteristics that affect visual perception (VP) and elucidate lesion locations correlated with impaired VP. We reviewed 61 patients with stroke. Clinical assessments of a motor-free VP test were used to evaluate VP after stroke. Regression analyses were performed to examine predictors of impaired VP. We generated statistical maps of lesions related to impaired VP using voxel-based lesion symptom mapping (VLSM). The group of patients who had right hemispheric lesions had significantly low VP function. In a regression model, impaired VP was predicted by cognitive function, age, lesion volume, and right hemispheric lesion. Using VLSM, we found lesion location associated with impaired VP after adjusting for age, lesion volume, and Korean version of mini mental status exam. The results showed a lesion pattern with predominant distribution in the right parietal lobe and deep white matter. Age, lesion volume, and cognitive impairment affected the results of VP tests. Even after adjustments, we found that lesions responsible for impaired VP were located in the right parietal lobe and deep white matter. This result confirmed right hemispheric dominance for VP using VLSM. Clin. Anat. 32:689-696, 2019. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Min Jeong Leem
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seoungnam-si, Republic of Korea
| | - Hyun Im Moon
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seoungnam-si, Republic of Korea
| | - Seo Yeon Yoon
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seoungnam-si, Republic of Korea
| | - Hyo Jeong Lee
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seoungnam-si, Republic of Korea
| | - Je-Shik Nam
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seoungnam-si, Republic of Korea
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15
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Allen JW, Yazdani M, Kang J, Magnussen MJ, Qiu D, Hu W. Patients with Mild Cognitive Impairment May be Stratified by Advanced Diffusion Metrics and Neurocognitive Testing. J Neuroimaging 2018; 29:79-84. [PMID: 30548151 DOI: 10.1111/jon.12588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/21/2018] [Accepted: 11/23/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Mild cognitive impairment (MCI) is a prevalent disorder, with a subset of patients progressing to dementia each year. Although MCI may be subdivided into amnestic or vascular types as well as into single or multiple cognitive domain involvement, most prior studies using advanced diffusion imaging have not accounted for these categories. The purpose of the current study was to determine if the pattern of diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) metrics in patients with amnestic MCI (aMCI) correlate to specific cognitive domain impairments. METHODS Nineteen consecutive patients with aMCI referred for brain magnetic resonance imaging (MRI) were included. All subjects underwent neurocognitive testing. A z-score was calculated for each domain and a composite of all four domains. Brain MRI included standard structural imaging and diffusion imaging. Volumetric, DTI, and DKI metrics were calculated and statistical analysis was performed with adjustments for multiple measures and comparisons. RESULTS Statistically significant correlations between diffusion metrics and cognitive z-scores were detected: visuospatial-visuoconstructional z-scores only correlated with alterations in the corpus callosum splenium, executive functioning z-scores with the corpus callosum genu, memory testing z-scores with the left hippocampus, and composite z-scores with the anterior centrum semiovale. CONCLUSION Neuroimaging studies of patients with aMCI to date have assumed a population with homogeneous cognitive impairment. Our results demonstrate selective patterns of regional diffusion metric alterations correlate to specific cognitive domain impairments. Future studies should account for this heterogeneity, and this may also be useful for prognostication.
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Affiliation(s)
- Jason W Allen
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA.,Department of Neurology, Emory University, Atlanta, GA
| | - Milad Yazdani
- Department of Radiology and Radiological Sciences, Medical University of South Carolina, Charleston, SC
| | - Jian Kang
- Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | | | - Deqiang Qiu
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA
| | - William Hu
- Department of Neurology, Emory University, Atlanta, GA
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16
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Mapping functional brain organization: Rethinking lesion symptom mapping and advanced neuroimaging methods in the understanding of human cognition. Neuropsychologia 2018; 115:1-4. [PMID: 29704522 DOI: 10.1016/j.neuropsychologia.2018.04.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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Li J, Wu L, Tang Y, Zhou A, Wang F, Xing Y, Jia J. Differentiation of neuropsychological features between posterior cortical atrophy and early onset Alzheimer's disease. BMC Neurol 2018; 18:65. [PMID: 29747584 PMCID: PMC5944104 DOI: 10.1186/s12883-018-1068-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 05/02/2018] [Indexed: 12/30/2022] Open
Abstract
Background Posterior cortical atrophy (PCA) is a group of clinical syndromes characterized by visuospatial and visuoperceptual impairment, with memory relatively preserved. Although PCA is pathologically almost identical to Alzheimer’s disease (AD), they have different cognitive features. Those differences have only rarely been reported in any Chinese population. The purpose of the study is to establish neuropsychological tests that distinguish the clinical features of PCA from early onset AD (EOAD). Methods Twenty-one PCA patients, 20 EOAD patients, and 20 healthy controls participated in this study. Patients had disease duration of ≤4 years. All participants completed a series of neuropsychological tests to evaluate their visuospatial, visuoperceptual, visuo-constructive, language, executive function, memory, calculation, writing, and reading abilities. The cognitive features of PCA and EOAD were compared. Results All the neuropsychological test scores showed that both the PCA and EOAD patients were significantly more impaired than people in the control group. However, PCA patients were significantly more impaired than EOAD patients in visuospatial, visuoperceptual, and visuo-constructive function, as well as in handwriting, and reading Chinese characters. Conclusions The profile of neuropsychological test results highlights cognitive features that differ between PCA and EOAD. One surprising result is that the two syndromes could be distinguished by patients’ ability to read and write Chinese characters. Tests based on these characteristics could therefore form a brief PCA neuropsychological examination that would improve the diagnosis of PCA.
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Affiliation(s)
- Jieying Li
- Innovation Center for Neurological Disorders, Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, People's Republic of China.,The Second People's Hospital of Guiyang, Guizhou, People's Republic of China
| | - Liyong Wu
- Innovation Center for Neurological Disorders, Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yi Tang
- Innovation Center for Neurological Disorders, Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Aihong Zhou
- Innovation Center for Neurological Disorders, Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Fen Wang
- Innovation Center for Neurological Disorders, Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yi Xing
- Innovation Center for Neurological Disorders, Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jianping Jia
- Innovation Center for Neurological Disorders, Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, People's Republic of China. .,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, People's Republic of China. .,Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, People's Republic of China. .,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, People's Republic of China. .,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, People's Republic of China. .,National Clinical Research Center for Geriatric Disorders, Beijing, People's Republic of China.
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18
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Rodrigues JDC, Machado WDL, da Fontoura DR, Almeida AG, Brondani R, Martins SO, Ruschel Bandeira D, Salles JFD. What neuropsychological functions best discriminate performance in adults post-stroke? APPLIED NEUROPSYCHOLOGY-ADULT 2018; 26:452-464. [DOI: 10.1080/23279095.2018.1442334] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Jaqueline de Carvalho Rodrigues
- Universidade Federal do Rio Grande do Sul, Departamento de Psicologia do Desenvolvimento e da Personalidade, Porto Alegre, Brazil
| | - Wagner de Lara Machado
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências da Saúde, Programa de Pós-graduação em Psicologia, Campinas, Brazil
| | | | | | | | - Sheila Ouriques Martins
- Universidade Federal do Rio Grande do Sul, Departamento de Medicina Interna, Porto Alegre, Brazil
| | - Denise Ruschel Bandeira
- Universidade Federal do Rio Grande do Sul, Departamento de Psicologia do Desenvolvimento e da Personalidade, Porto Alegre, Brazil
| | - Jerusa Fumagalli de Salles
- Universidade Federal do Rio Grande do Sul, Departamento de Psicologia do Desenvolvimento e da Personalidade, Porto Alegre, Brazil
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19
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Abstract
Since the classic papers of Kleist, Mayer Gross, and Critchley, constructional apraxia (CA) has been considered to be a typical sign of a parietal lobe lesion, and as a precious tool to appreciate the spatial abilities subserved by this lobe. However, the development of more sophisticated neuropsychologic models and methods of investigation has revealed several problematic aspects. It has become increasingly clear that CA is a heterogeneous construct that can be examined with very different tasks, that are only mildly interconnected, and tap various kinds of visuospatial, perceptual, attentional, planning, and motor mechanisms. On the basis of these considerations, the relationships between parietal lobe functions and constructional activities must be considered, taking into account on the one hand the heterogeneity of the tasks and of the cognitive functions requested by different kinds of constructional activities and, on the other hand, the plurality of functions and of processing streams linking different parts of the parietal lobes to the occipital and frontal lobes.
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20
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Trojano L, Gainotti G. Drawing Disorders in Alzheimer's Disease and Other Forms of Dementia. J Alzheimers Dis 2017; 53:31-52. [PMID: 27104898 DOI: 10.3233/jad-160009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Drawing is a multicomponential process that can be impaired by many kinds of brain lesions. Drawing disorders are very common in Alzheimer's disease and other forms of dementia, and can provide clinical information for the distinction of the different dementing diseases. In our review we started from an overview of the neural and cognitive bases of drawing, and from a recollection of the drawing tasks more frequently used for assessing individuals with dementia. Then, we analyzed drawing disorders in dementia, paying special attention to those observed in Alzheimer's disease, from the prodromal stages of the amnesic mild cognitive impairment to the stages of full-blown dementia, both in the sporadic forms with late onset in the entorhino-hippocampal structures and in those with early onset in the posterior neocortical structures. We reviewed the drawing features that could differentiate Alzheimer's disease from vascular dementia and from the most frequent forms of degenerative dementia, namely frontotemporal dementia and Lewy body disease. Finally, we examined some peculiar aspects of drawing disorders in dementia, such as perseverations, rotations, and closing-in. We argue that a careful analysis of drawing errors helps to differentiate the different forms of dementia more than overall accuracy in drawing.
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Affiliation(s)
- Luigi Trojano
- Department of Psychology, Second University of Naples, Italy.,S. Maugeri Foundation, Scientific Institute of Telese Terme (BN), Italy
| | - Guido Gainotti
- Center for Neuropsychological Research, Institute of Neurology, Catholic University, Rome, Italy.,IRCCS Fondazione Santa Lucia, Department of Clinical and Behavioral Neurology, Rome, Italy
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21
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Jane Moore M, Demeyere N. Neglect Dyslexia in Relation to Unilateral Visuospatial Neglect: A Review. AIMS Neurosci 2017. [DOI: 10.3934/neuroscience.2017.4.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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22
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Jane Moore M, Demeyere N. Neglect Dyslexia in Relation to Unilateral Visuospatial Neglect: A Review. AIMS Neurosci 2017. [DOI: 10.3934/neuroscience.2017.4.148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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23
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Satoh M, Mori C, Matsuda K, Ueda Y, Tabei KI, Kida H, Tomimoto H. Improved Necker Cube Drawing-Based Assessment Battery for Constructional Apraxia: The Mie Constructional Apraxia Scale (MCAS). Dement Geriatr Cogn Dis Extra 2016; 6:424-436. [PMID: 27790241 PMCID: PMC5075750 DOI: 10.1159/000449245] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background/Aims Constructional apraxia (CA) is usually diagnosed by having patients draw figures; however, the reported assessments only evaluate the drawn figure. We designed a new assessment battery for CA (the Mie Constructional Apraxia Scale, MCAS) which includes both the shape and drawing process, and investigated its utility against other assessment methods. Methods We designed the MCAS, and evaluated inter- and intrarater reliability. We also investigated the sensitivity, specificity, and positive and negative predictive values in dementia patients, and compared MCAS assessment with other reported batteries in the same subjects. Results Moderate interrater reliability was shown for speech therapists with limited experience. Moderate to substantial intrarater reliability was shown several weeks after initial assessment. When cutoff scores and times were set at 2/3 points and 39/40 s, sensitivity and specificity were 77.1 and 70.4%, respectively, with positive and negative predictive values of 80.0 and 66.7%, respectively. Dementia patients had significantly worse scores and times for Necker cube drawing than an elderly control group on the MCAS, and on other assessments. Conclusions We conclude that the MCAS, which includes both the assessment of the drawn Necker cube shape and the drawing process, is useful for detecting even mild CA.
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Affiliation(s)
- Masayuki Satoh
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Chika Mori
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Kana Matsuda
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Yukito Ueda
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Ken-Ichi Tabei
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Hirotaka Kida
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Hidekazu Tomimoto
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
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24
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Chen H, Pan X, Lau JKL, Bickerton WL, Pradeep B, Taheri M, Humphreys G, Rotshtein P. Lesion-symptom mapping of a complex figure copy task: A large-scale PCA study of the BCoS trial. NEUROIMAGE-CLINICAL 2016; 11:622-634. [PMID: 27182489 PMCID: PMC4857225 DOI: 10.1016/j.nicl.2016.04.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 04/02/2016] [Accepted: 04/12/2016] [Indexed: 11/18/2022]
Abstract
Complex figure copying is a commonly used neuropsychological test. Here we explored the neural basis of the factors underlying complex figure copying (CFC), using data from the Birmingham Cognitive Screen (BCoS) in a large group of sub-acute, ischemic stroke patients (239). We computed two analyses: in the first we assessed the contribution of co-morbid deficits (i.e. in gesture processing, object use, visual neglect, pictures naming and sustained attention) to the lesions associated with CFC. In a second analysis a Principle Component Analysis (PCA) was used to isolate different underlying task components and to link to clinical neuroimaging scans. A voxel-based morphometry (VBM) analysis showed that poor CFC performance was associated with lesions to bi-lateral thalamus, lingual, right fusiform and right inferior parietal cortices (rIPC). The latter association with the posterior parietal cortex was diminished after controlling for neglect. Follow up analysis showed the neglect partially mediated the correlation of CFC and rIPC. The PCA revealed three main underlying components: (1) a component associated with high-level motor control common to different measures of apraxia and linked to the left postcentral gyrus, the right thalamus and middle frontal gyrus; (2) a visuo-motor transformation component unique to the CFC and associated with lesions to the posterior occipital and sensory cortices; (3) a component associated with multistep object use tasks which was correlated with lesions to the left inferior frontal orbital gyrus, the right fusiform and cerebellum. Using clinical symptoms, cognitive profiles and lesion mapping we showed that beyond visual perception, CFC performance is supported by three functional networks: one for high-level motor control, a visuo-motor transformation component, and multistep object use network.
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Affiliation(s)
- Haobo Chen
- Department of Neurology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou 510000, PR China; School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Xiaoping Pan
- Department of Neurology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou 510000, PR China
| | | | | | - Boddana Pradeep
- Consultant in Old Age Psychiatry, Avon & Wiltshire NHS Trust, Green Lane Hospital, Devizes, Wiltshire SN105 DS, UK
| | - Maliheh Taheri
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Glyn Humphreys
- Department of Experimental Psychology, University of Oxford, Oxford OX1 3UD, UK
| | - Pia Rotshtein
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
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25
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Abstract
Spatial neglect and extinction are induced by posterior superior temporal and inferior parietal dysfunction. In patients with logopenic progressive aphasia (LPA) these structures are often degenerated, but there are no reports of these disorders being associated. A 53-year-old man with the signs of LPA revealed right-sided spatial neglect on line bisection and drawing tests as well as multimodal extinction. MRI showed left hemispheric posterior temporoparietal atrophy. Since injury to the core structures for these aphasic and attentional syndromes overlaps, patients with LPA should be screened for spatial neglect and extinction.
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Affiliation(s)
- Eduardo M Zilli
- a Department of Neurology , University of Florida College of Medicine, The Center for Neuropsychological Studies, and the Veterans Affairs Medical Center , Gainesville , FL , USA
| | - Kenneth M Heilman
- a Department of Neurology , University of Florida College of Medicine, The Center for Neuropsychological Studies, and the Veterans Affairs Medical Center , Gainesville , FL , USA
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26
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Chechlacz M, Mantini D, Gillebert CR, Humphreys GW. Asymmetrical white matter networks for attending to global versus local features. Cortex 2015; 72:54-64. [PMID: 25727548 PMCID: PMC4643681 DOI: 10.1016/j.cortex.2015.01.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 11/11/2014] [Accepted: 01/29/2015] [Indexed: 11/30/2022]
Abstract
The ability to draw objects is a complex process depending on an array of cognitive mechanisms including routines for spatial coding, attention and the processing of both local and global features. Previous studies using both neuropsychological and neuroimaging data have reported hemispheric asymmetries in attending to local versus global features linked to a variety of cortical loci. However, it has not been examined to date whether such asymmetries exist at the level of white matter pathways sub-serving global/local attention. The current study provides a comprehensive analysis of brain-behaviour relationships in the processing of local versus global features based on data from a large cohort of sub-acute stroke patients (n = 248) and behavioural measures from a complex figure copy task. The data analysis used newly developed methods for automated delineation of stroke lesions combined with track-wise lesion deficits procedures. We found (i) that reproduction of local features in figure copying was supported by a neural network confined to the left hemisphere, consisting of cortical loci within parietal, occipital and insular lobes and interconnected by the inferior-fronto-occipital fasciculus (IFOF), and (ii) that global feature processing was associated with a right hemisphere network interconnected by the third branch of the superior longitudinal fasciculus and the long segment of the perisylvian network. The data support the argument that asymmetrical white matter disconnections within long-range association pathways predict poor complex figure drawing resulting from deficits in hierarchical representation. We conclude that hemispheric asymmetries in attending to local versus global features exist on the level of both cortical loci and the supporting white matter pathways.
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Affiliation(s)
| | - Dante Mantini
- Department of Experimental Psychology, University of Oxford, Oxford, UK; Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | | | - Glyn W Humphreys
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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27
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Bieńkiewicz MMN, Brandi M, Hughes C, Voitl A, Hermsdörfer J. The complexity of the relationship between neuropsychological deficits and impairment in everyday tasks after stroke. Brain Behav 2015; 5:e00371. [PMID: 26516606 PMCID: PMC4614052 DOI: 10.1002/brb3.371] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 06/17/2015] [Accepted: 07/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND PURPOSE A large body of research reports that stroke patients are debilitated in terms of daily independence after dismissal from the hospital unit. Patients struggle with the use of daily objects or performing complex actions. Differences between individual deficits of patients are often associated with the site of the brain damage. However, clinical studies suggest that patients exhibit varied constellations of action-associated difficulties and neuropsychological deficits. There is a lack of conclusive evidence indicating how different neuropsychological symptoms link to the impaired ability to perform activities of daily living (ADL). MATERIALS AND METHODS To further address this matter, in this study we compared the behavior of patients with left brain damage (LBD) and right brain damage (RBD) following stroke in two naturalistic task scenarios (tea making and document filing), and compared the committed action errors to the neuropsychological screening results. RESULTS We observed mild to severe impairments in both the LBD and RBD groups amounting to 37-55% of failure rate in attainment of action goal. Interestingly, the performance on both tasks was not correlated to each other, suggesting that the tasks involved a different set of higher cognitive functions. Despite similar behavioral manifestations, in the LBD group poor task performance was related to deficits in praxis performance and unilateral tactile and visual extinction. The presence of aphasia did not correlate with task performance, except for a link between low scores in Aachen aphasia test scales and misestimation error in the tea making task. In the RBD group, difficulties with performance were primarily linked to deficit in praxis and unilateral visual extinction. CONCLUSIONS Despite similar behavior, the underlying mechanisms of the deficits after stroke might be different (in patients with LBD and RBD) and reveal complex interlinks of cognitive networks involved in the ability to carry on everyday tasks.
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Affiliation(s)
- Marta M. N. Bieńkiewicz
- Department of Sport and Health SciencesInstitute of Human Movement ScienceTechnische Universität MünchenMünchenGermany
| | - Marie‐Luise Brandi
- Department of Sport and Health SciencesInstitute of Human Movement ScienceTechnische Universität MünchenMünchenGermany
- Graduate School of Systemic NeurosciencesLudwig‐Maximilians‐Universität MünchenPlanegg‐MartinsriedGermany
| | - Charmayne Hughes
- Department of Sport and Health SciencesInstitute of Human Movement ScienceTechnische Universität MünchenMünchenGermany
| | - Anna Voitl
- Department of Sport and Health SciencesInstitute of Human Movement ScienceTechnische Universität MünchenMünchenGermany
| | - Joachim Hermsdörfer
- Department of Sport and Health SciencesInstitute of Human Movement ScienceTechnische Universität MünchenMünchenGermany
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Humphreys GW, Chechlacz M. A Neural Decomposition of Visual Search Using Voxel-based Morphometry. J Cogn Neurosci 2015; 27:1854-69. [DOI: 10.1162/jocn_a_00828] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract
The ability to search efficiently for visual targets among distractors can break down after a variety of brain lesions, but the specific processes affected by the lesions are unclear. We examined search over space (conjunction search) and over time plus space (preview search) in a consecutive series of patients with acquired brain lesions. We also assessed performance on standard neuropsychological measures of visuospatial short-term memory (Corsi Block), sustained attention and memory updating (the contrast between forward and backward digit span), and visual neglect. Voxel-based morphometry analyses revealed regions in the occipital (middle occipital gyrus), posterior parietal (angular gyrus), and temporal cortices (superior and middle temporal gyri extending to the insula), along with underlying white matter pathways, associated with poor search. Going beyond standard voxel-based morphometry analyses, we then report correlation measures of structural damage in these regions and the independent neuropsychological measures of other cognitive functions. We find distinct patterns of correlation in areas linked to poor search, suggesting that the areas play functionally different roles in search. We conclude that neuropsychological disorders of search can be linked to necessary and distinct cognitive functions, according to the site of lesion.
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Massa MS, Wang N, Bickerton WL, Demeyere N, Riddoch MJ, Humphreys GW. On the importance of cognitive profiling: A graphical modelling analysis of domain-specific and domain-general deficits after stroke. Cortex 2015; 71:190-204. [PMID: 26232552 DOI: 10.1016/j.cortex.2015.06.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 11/08/2014] [Accepted: 06/10/2015] [Indexed: 12/11/2022]
Abstract
Cognitive problems following stroke are typically analysed using either short but relatively uninformative general tests or through detailed but time consuming tests of domain specific deficits (e.g., in language, memory, praxis). Here we present an analysis of neuropsychological deficits detected using a screen designed to fall between other screens by being 'broad' (testing multiple cognitive abilities) but 'shallow' (sampling the abilities briefly, to be time efficient) - the BCoS. Assessment using the Birmingham Cognitive Screen (BCoS) enables the relations between 'domain specific' and 'domain general' cognitive deficits to be evaluated as the test generates an overall cognitive profile for individual patients. We analysed data from 287 patients tested at a sub-acute stage of stroke (<3 months). Graphical modelling techniques were used to investigate the associative structure and conditional independence between deficits within and across the domains sampled by BCoS (attention and executive functions, language, memory, praxis and number processing). The patterns of deficit within each domain conformed to existing cognitive models. However, these within-domain patterns underwent substantial change when the whole dataset was modelled, indicating that domain-specific deficits can only be understood in relation to linked changes in domain-general processes. The data point to the importance of using over-arching cognitive screens, measuring domain-general as well as domain-specific processes, in order to account for neuropsychological deficits after stroke. The paper also highlights the utility of using graphical modelling to understand the relations between cognitive components in complex datasets.
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Affiliation(s)
- M Sofia Massa
- Department of Statistics, Oxford University, Oxford, UK
| | - Naxian Wang
- Department of Statistics, Oxford University, Oxford, UK
| | | | - Nele Demeyere
- Department of Experimental Psychology, Oxford University, Oxford, UK
| | - M Jane Riddoch
- Department of Experimental Psychology, Oxford University, Oxford, UK
| | - Glyn W Humphreys
- Department of Experimental Psychology, Oxford University, Oxford, UK.
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