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Pan H, Liu TW, Ng SSM, Chen PM, Chung RCK, Lam SSL, Li CSK, Chan CCC, Lai CWK, Ng WWL, Tang MWS, Hui E, Woo J. Effects of mirror therapy with electrical stimulation for upper limb recovery in people with stroke: a systematic review and meta-analysis. Disabil Rehabil 2024:1-16. [PMID: 38334111 DOI: 10.1080/09638288.2024.2310757] [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: 06/21/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE To provide updated evidence about the effects of MT with ES for recovering upper extremities motor function in people with stroke. METHODS Systematic review and meta-analysis were completed. Methodological quality was assessed using the version 2 of the Cochrane risk-of-bias tool. The GRADE approach was employed to assess the certainty of evidence. RESULTS A total of 16 trials with 773 participants were included in this review. The results demonstrated that MT with ES was more effective than sham (standardized mean difference [SMD], 1.89 [1.52-2.26]) and ES alone (SMD, 0.42 [0.11-0.73]) with low quality of evidence, or MT alone (SMD, 0.47[0.04-0.89]) with low quality of evidence for improving upper extremity motor control assessed using Fugl-Meyer Assessment. MT with ES had significant improvement of (MD, 6.47 [1.92-11.01]) the upper extremity gross gripping function assessed using the Action Research Arm Test compared with MT alone with low quality of evidence. MT combined with ES was more effective than sham group (SMD, 1.17 [0.42-1.93) for improving the ability to perform activities of daily living with low quality of evidence assessed using Motor Activity Log. CONCLUSION MT with ES may be effective in improving upper limb motor recovery in people with stroke.
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Affiliation(s)
- Hong Pan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Tai Wa Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China (SAR)
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Pei Ming Chen
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Raymond C K Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Stefanie S L Lam
- Department of Physiotherapy, Shatin Hospital, Hong Kong, China (SAR)
| | - Carol S K Li
- Department of Physiotherapy, Shatin Hospital, Hong Kong, China (SAR)
| | - Charles C C Chan
- Department of Physiotherapy, Shatin Hospital, Hong Kong, China (SAR)
| | - Charles W K Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Winnie W L Ng
- Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China (SAR)
| | - Maria W S Tang
- Department of Medicine and Geriatrics, Shatin Hospital, Hong Kong, China (SAR)
| | - Elsie Hui
- Department of Medicine and Geriatrics, Shatin Hospital, Hong Kong, China (SAR)
| | - Jean Woo
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (SAR)
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Nava E, Giraud M, Bolognini N. The emergence of the multisensory brain: From the womb to the first steps. iScience 2024; 27:108758. [PMID: 38230260 PMCID: PMC10790096 DOI: 10.1016/j.isci.2023.108758] [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] [Indexed: 01/18/2024] Open
Abstract
The becoming of the human being is a multisensory process that starts in the womb. By integrating spontaneous neuronal activity with inputs from the external world, the developing brain learns to make sense of itself through multiple sensory experiences. Over the past ten years, advances in neuroimaging and electrophysiological techniques have allowed the exploration of the neural correlates of multisensory processing in the newborn and infant brain, thus adding an important piece of information to behavioral evidence of early sensitivity to multisensory events. Here, we review recent behavioral and neuroimaging findings to document the origins and early development of multisensory processing, particularly showing that the human brain appears naturally tuned to multisensory events at birth, which requires multisensory experience to fully mature. We conclude the review by highlighting the potential uses and benefits of multisensory interventions in promoting healthy development by discussing emerging studies in preterm infants.
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Affiliation(s)
- Elena Nava
- Department of Psychology & Milan Centre for Neuroscience (NeuroMI), University of Milan-Bicocca, Milan, Italy
| | - Michelle Giraud
- Department of Psychology & Milan Centre for Neuroscience (NeuroMI), University of Milan-Bicocca, Milan, Italy
| | - Nadia Bolognini
- Department of Psychology & Milan Centre for Neuroscience (NeuroMI), University of Milan-Bicocca, Milan, Italy
- Laboratory of Neuropsychology, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Sattin D, Parma C, Lunetta C, Zulueta A, Lanzone J, Giani L, Vassallo M, Picozzi M, Parati EA. An Overview of the Body Schema and Body Image: Theoretical Models, Methodological Settings and Pitfalls for Rehabilitation of Persons with Neurological Disorders. Brain Sci 2023; 13:1410. [PMID: 37891779 PMCID: PMC10605253 DOI: 10.3390/brainsci13101410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
Given the widespread debate on the definition of the terms "Body Schema" and "Body Image", this article presents a broad overview of the studies that have investigated the nature of these types of body representations, especially focusing on the innovative information about these two representations that could be useful for the rehabilitation of patients with different neurological disorders with motor deficits (especially those affecting the upper limbs). In particular, we analyzed (i) the different definitions and explicative models proposed, (ii) the empirical settings used to test them and (iii) the clinical and rehabilitative implications derived from the application of interventions on specific case reports. The growing number of neurological diseases with motor impairment in the general population has required the development of new rehabilitation techniques and a new phenomenological paradigm placing body schema as fundamental and intrinsic parts for action in space. In this narrative review, the focus was placed on evidence from the application of innovative rehabilitation techniques and case reports involving the upper limbs, as body parts particularly involved in finalistic voluntary actions in everyday life, discussing body representations and their functional role.
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Affiliation(s)
- Davide Sattin
- Istituti Clinici Scientifici Maugeri IRCCS, Health Directorate, Via Camaldoli 64, 20138 Milan, Italy; (D.S.); (M.V.)
| | - Chiara Parma
- Istituti Clinici Scientifici Maugeri IRCCS, Health Directorate, Via Camaldoli 64, 20138 Milan, Italy; (D.S.); (M.V.)
| | - Christian Lunetta
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department-ALS Unit, Via Camaldoli 64, 20138 Milan, Italy;
| | - Aida Zulueta
- Istituti Clinici Scientifici Maugeri IRCCS, Labion, Via Camaldoli 64, 20138 Milan, Italy;
| | - Jacopo Lanzone
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department, Via Camaldoli 64, 20138 Milan, Italy; (J.L.); (L.G.); (E.A.P.)
| | - Luca Giani
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department, Via Camaldoli 64, 20138 Milan, Italy; (J.L.); (L.G.); (E.A.P.)
| | - Marta Vassallo
- Istituti Clinici Scientifici Maugeri IRCCS, Health Directorate, Via Camaldoli 64, 20138 Milan, Italy; (D.S.); (M.V.)
- Center for Clinical Ethics, Biotechnology and Life Sciences Department, Insubria University, 21100 Varese, Italy;
| | - Mario Picozzi
- Center for Clinical Ethics, Biotechnology and Life Sciences Department, Insubria University, 21100 Varese, Italy;
| | - Eugenio Agostino Parati
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department, Via Camaldoli 64, 20138 Milan, Italy; (J.L.); (L.G.); (E.A.P.)
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Leharanger M, Rodriguez Martinez EA, Balédent O, Vandromme L. Familiarization with Mixed Reality for Individuals with Autism Spectrum Disorder: An Eye Tracking Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:6304. [PMID: 37514598 PMCID: PMC10383879 DOI: 10.3390/s23146304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/30/2023]
Abstract
Mixed Reality (MR) technology is experiencing significant growth in the industrial and healthcare sectors. The headset HoloLens 2 displays virtual objects (in the form of holograms) in the user's environment in real-time. Individuals with Autism Spectrum Disorder (ASD) exhibit, according to the DSM-5, persistent deficits in communication and social interaction, as well as a different sensitivity compared to neurotypical (NT) individuals. This study aims to propose a method for familiarizing eleven individuals with severe ASD with the HoloLens 2 headset and the use of MR technology through a tutorial. The secondary objective is to obtain quantitative learning indicators in MR, such as execution speed and eye tracking (ET), by comparing individuals with ASD to neurotypical individuals. We observed that 81.81% of individuals with ASD successfully familiarized themselves with MR after several sessions. Furthermore, the visual activity of individuals with ASD did not differ from that of neurotypical individuals when they successfully familiarized themselves. This study thus offers new perspectives on skill acquisition indicators useful for supporting neurodevelopmental disorders. It contributes to a better understanding of the neural mechanisms underlying learning in MR for individuals with ASD.
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Affiliation(s)
- Maxime Leharanger
- UR 7516 Laboratory CHIMERE, University of Picardie Jules Verne, 80000 Amiens, France
- Institut Faire Face, CHU Amiens, 80054 Amiens, France
| | - Eder Alejandro Rodriguez Martinez
- UR 7516 Laboratory CHIMERE, University of Picardie Jules Verne, 80000 Amiens, France
- Institut Faire Face, CHU Amiens, 80054 Amiens, France
| | - Olivier Balédent
- UR 7516 Laboratory CHIMERE, University of Picardie Jules Verne, 80000 Amiens, France
- Institut Faire Face, CHU Amiens, 80054 Amiens, France
| | - Luc Vandromme
- UR 7516 Laboratory CHIMERE, University of Picardie Jules Verne, 80000 Amiens, France
- Institut Faire Face, CHU Amiens, 80054 Amiens, France
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Tesio L, Caronni A, Russo C, Felisari G, Banco E, Simone A, Scarano S, Bolognini N. Reversed Mirror Therapy (REMIT) after Stroke-A Proof-of-Concept Study. Brain Sci 2023; 13:847. [PMID: 37371327 DOI: 10.3390/brainsci13060847] [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: 04/27/2023] [Revised: 05/13/2023] [Accepted: 05/20/2023] [Indexed: 06/29/2023] Open
Abstract
In mirror training (MIT), stroke patients strive to move their hands while looking at the reflected image of the unaffected one. The recruitment of the mirror neurons and visual-proprioceptive conflict are expected to facilitate the paretic voluntary movement. Here, a reversed MIT (REMIT) is presented, which requires moving hands while looking at the reflected image of the paretic one, giving the illusion of being unable to move the unimpaired hand. This study compares MIT and REMIT on post-stroke upper-limb recovery to gain clues on the mechanism of action of mirror therapies. Eight chronic stroke patients underwent two weeks of MIT and REMIT (five sessions each) in a crossover design. Upper-limb Fugl-Meyer, Box and Block and handgrip strength tests were administered at baseline and treatments end. The strength of the mirror illusion was evaluated after each session. MIT induced a larger illusory effect. The Fugl-Meyer score improved to the same extent after both treatments. No changes occurred in the Box and Block and the handgrip tests. REMIT and MIT were equally effective on upper-limb dexterity, challenging the exclusive role of mirror neurons. Contrasting learned nonuse through an intersensory conflict might provide the rationale for both forms of mirror-based rehabilitation after stroke.
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Affiliation(s)
- Luigi Tesio
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, Ospedale San Luca, 20149 Milano, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milano, Italy
| | - Antonio Caronni
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, Ospedale San Luca, 20149 Milano, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milano, Italy
| | - Cristina Russo
- Department of Psychology, University of Milano-Bicocca, 20126 Milano, Italy
| | - Giorgio Felisari
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, Ospedale San Luca, 20149 Milano, Italy
| | - Elisabetta Banco
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, Ospedale San Luca, 20149 Milano, Italy
| | - Anna Simone
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, Ospedale San Luca, 20149 Milano, Italy
| | - Stefano Scarano
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, Ospedale San Luca, 20149 Milano, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milano, Italy
| | - Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, 20126 Milano, Italy
- Neuropsychological Laboratory, Istituto Auxologico Italiano, IRCCS, 20122 Milano, Italy
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de Freitas Zanona A, Romeiro da Silva AC, Baltar do Rego Maciel A, Shirahige Gomes do Nascimento L, Bezerra da Silva A, Piscitelli D, Monte-Silva K. Sensory and motor cortical excitability changes induced by rTMS and sensory stimulation in stroke: A randomized clinical trial. Front Neurosci 2023; 16:985754. [PMID: 36760794 PMCID: PMC9907709 DOI: 10.3389/fnins.2022.985754] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 12/29/2022] [Indexed: 01/26/2023] Open
Abstract
Background The ability to produce coordinated movement is dependent on dynamic interactions through transcallosal fibers between the two cerebral hemispheres of the brain. Although typically unilateral, stroke induces changes in functional and effective connectivity across hemispheres, which are related to sensorimotor impairment and stroke recovery. Previous studies have focused almost exclusively on interhemispheric interactions in the primary motor cortex (M1). Objective To identify the presence of interhemispheric asymmetry (ASY) of somatosensory cortex (S1) excitability and to investigate whether S1 repetitive transcranial magnetic stimulation (rTMS) combined with sensory stimulation (SS) changes excitability in S1 and M1, as well as S1 ASY, in individuals with subacute stroke. Methods A randomized clinical trial. Participants with a single episode of stroke, in the subacute phase, between 35 and 75 years old, were allocated, randomly and equally balanced, to four groups: rTMS/sham SS, sham rTMS/SS, rTMS/SS, and sham rTMS/Sham SS. Participants underwent 10 sessions of S1 rTMS of the lesioned hemisphere (10 Hz, 1,500 pulses) followed by SS. SS was applied to the paretic upper limb (UL) (active SS) or non-paretic UL (sham SS). TMS-induced motor evoked potentials (MEPs) of the paretic UL and somatosensory evoked potential (SSEP) of both ULs assessed M1 and S1 cortical excitability, respectively. The S1 ASY index was measured before and after intervention. Evaluator, participants and the statistician were blinded. Results Thirty-six participants divided equally into groups (nine participants per group). Seven patients were excluded from MEP analysis because of failure to produce consistent MEP. One participant was excluded in the SSEP analysis because no SSEP was detected. All somatosensory stimulation groups had decreased S1 ASY except for the sham rTMS/Sham SS group. When compared with baseline, M1 excitability increased only in the rTMS/SS group. Conclusion S1 rTMS and SS alone or in combination changed S1 excitability and decreased ASY, but it was only their combination that increased M1 excitability. Clinical trial registration clinicaltrials.gov, identifier (NCT03329807).
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Affiliation(s)
- Aristela de Freitas Zanona
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil,Occupational Therapy Department and Post-Graduate Program in Applied Health Sciences, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | | | - Adriana Baltar do Rego Maciel
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | | | - Amanda Bezerra da Silva
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy,Department of Kinesiology, University of Connecticut, Storrs, CT, United States,*Correspondence: Daniele Piscitelli, ,
| | - Katia Monte-Silva
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
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Risso G, Bassolino M. Assess and rehabilitate body representations via (neuro)robotics: An emergent perspective. Front Neurorobot 2022; 16:964720. [PMID: 36160286 PMCID: PMC9498221 DOI: 10.3389/fnbot.2022.964720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022] Open
Abstract
The perceptions of our own body (e.g., size and shape) do not always coincide with its real characteristics (e.g., dimension). To track the complexity of our perception, the concept of mental representations (model) of the body has been conceived. Body representations (BRs) are stored in the brain and are maintained and updated through multiple sensory information. Despite being altered in different clinical conditions and being tightly linked with self-consciousness, which is one of the most astonishing features of the human mind, the BRs and, especially, the underlying mechanisms and functions are still unclear. In this vein, here we suggest that (neuro)robotics can make an important contribution to the study of BRs. The first section of the study highlights the potential impact of robotics devices in investigating BRs. Far to be exhaustive, we illustrate major examples of its possible exploitation to further improve the assessment of motor, haptic, and multisensory information building up the BRs. In the second section, we review the main evidence showing the contribution of neurorobotics-based (multi)sensory stimulation in reducing BRs distortions in various clinical conditions (e.g., stroke, amputees). The present study illustrates an emergent multidisciplinary perspective combining the neuroscience of BRs and (neuro)robotics to understand and modulate the perception and experience of one's own body. We suggest that (neuro)robotics can enhance the study of BRs by improving experimental rigor and introducing new experimental conditions. Furthermore, it might pave the way for the rehabilitation of altered body perceptions.
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Affiliation(s)
- Gaia Risso
- School of Health Sciences, Haute École spécialisée de Suisse occidentale (HES-SO) Valais-Wallis, Sion, Switzerland
- The Sense Innovation and Research Center, Sion, Switzerland
- Robotics, Brain and Cognitive Sciences (RBCS), Istituto Italiano di Tecnologia, Genoa, Italy
| | - Michela Bassolino
- School of Health Sciences, Haute École spécialisée de Suisse occidentale (HES-SO) Valais-Wallis, Sion, Switzerland
- The Sense Innovation and Research Center, Sion, Switzerland
- Laboratoire MySpace, Université de Lausanne, Lausanne, Switzerland
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de Freitas Zanona A, Romeiro da Silva AC, do Rego Maciel AB, Gomes do Nascimento LS, Bezerra da Silva A, Bolognini N, Monte-Silva K. Somatosensory Cortex Repetitive Transcranial Magnetic Stimulation and Associative Sensory Stimulation of Peripheral Nerves Could Assist Motor and Sensory Recovery After Stroke. Front Hum Neurosci 2022; 16:860965. [PMID: 35479184 PMCID: PMC9036089 DOI: 10.3389/fnhum.2022.860965] [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: 01/24/2022] [Accepted: 03/14/2022] [Indexed: 11/19/2022] Open
Abstract
Background We investigated whether transcranial magnetic stimulation (rTMS) over the primary somatosensory cortex (S1) and sensory stimulation (SS) could promote upper limb recovery in participants with subacute stroke. Methods Participants were randomized into four groups: rTMS/Sham SS, Sham rTMS/SS, rTMS/SS, and control group (Sham rTMS/Sham SS). Participants underwent ten sessions of sham or active rTMS over S1 (10 Hz, 1,500 pulses, 120% of resting motor threshold, 20 min), followed by sham or active SS. The SS involved active sensory training (exploring features of objects and graphesthesia, proprioception exercises), mirror therapy, and Transcutaneous electrical nerve stimulation (TENS) in the region of the median nerve in the wrist (stimulation intensity as the minimum intensity at which the participants reported paresthesia; five electrical pulses of 1 ms duration each at 10 Hz were delivered every second over 45 min). Sham stimulations occurred as follows: Sham rTMS, coil was held while disconnected from the stimulator, and rTMS noise was presented with computer loudspeakers with recorded sound from a real stimulation. The Sham SS received therapy in the unaffected upper limb, did not use the mirror and received TENS stimulation for only 60 seconds. The primary outcome was the Body Structure/Function: Fugl-Meyer Assessment (FMA) and Nottingham Sensory Assessment (NSA); the secondary outcome was the Activity/Participation domains, assessed with Box and Block Test, Motor Activity Log scale, Jebsen-Taylor Test, and Functional Independence Measure. Results Forty participants with stroke ischemic (n = 38) and hemorrhagic (n = 2), men (n = 19) and women (n = 21), in the subacute stage (10.6 ± 6 weeks) had a mean age of 62.2 ± 9.6 years, were equally divided into four groups (10 participants in each group). Significant somatosensory improvements were found in participants receiving active rTMS and active SS, compared with those in the control group (sham rTMS with sham SS). Motor function improved only in participants who received active rTMS, with greater effects when active rTMS was combined with active SS. Conclusion The combined use of SS with rTMS over S1 represents a more effective therapy for increasing sensory and motor recovery, as well as functional independence, in participants with subacute stroke. Clinical Trial Registration [clinicaltrials.gov], identifier [NCT03329807].
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Affiliation(s)
| | | | | | | | | | - Nadia Bolognini
- Department of Psychology, University of Milano Bicocca, Milan, Italy
- Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Katia Monte-Silva
- Applied Neuroscience Laboratory, Universidade Federal de Pernambuco, Recife, Brazil
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Giurgola S, Casati C, Stampatori C, Perucca L, Mattioli F, Vallar G, Bolognini N. Abnormal multisensory integration in relapsing–remitting multiple sclerosis. Exp Brain Res 2022; 240:953-968. [PMID: 35094114 PMCID: PMC8918188 DOI: 10.1007/s00221-022-06310-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 01/15/2022] [Indexed: 12/22/2022]
Abstract
Temporal Binding Window (TBW) represents a reliable index of efficient multisensory integration process, which allows individuals to infer which sensory inputs from different modalities pertain to the same event. TBW alterations have been reported in some neurological and neuropsychiatric disorders and seem to negatively affects cognition and behavior. So far, it is still unknown whether deficits of multisensory integration, as indexed by an abnormal TBW, are present even in Multiple Sclerosis. We addressed this issue by testing 25 participants affected by relapsing–remitting Multiple Sclerosis (RRMS) and 30 age-matched healthy controls. Participants completed a simultaneity judgment task (SJ2) to assess the audio-visual TBW; two unimodal SJ2 versions were used as control tasks. Individuals with RRMS showed an enlarged audio-visual TBW (width range = from − 166 ms to + 198 ms), as compared to healthy controls (width range = − 177/ + 66 ms), thus showing an increased tendency to integrate temporally asynchronous visual and auditory stimuli. Instead, simultaneity perception of unimodal (visual or auditory) events overall did not differ from that of controls. These results provide first evidence of a selective deficit of multisensory integration in individuals affected by RRMS, besides the well-known motor and cognitive impairments. The reduced multisensory temporal acuity is likely caused by a disruption of the neural interplay between different sensory systems caused by multiple sclerosis.
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Affiliation(s)
- Serena Giurgola
- Department of Psychology and NeuroMI, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy
| | - Carlotta Casati
- Neuropsychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | | | - Laura Perucca
- Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Flavia Mattioli
- Neuropsychology Unit, Spedali Civili of Brescia, Brescia, Italy
| | - Giuseppe Vallar
- Department of Psychology and NeuroMI, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy
- Neuropsychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Nadia Bolognini
- Department of Psychology and NeuroMI, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy
- Neuropsychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Lynch P, Monaghan K. Effects of sensory substituted functional training on balance, gait, and functional performance in neurological patient populations: A systematic review and meta-analysis. Heliyon 2021; 7:e08007. [PMID: 34604558 PMCID: PMC8473554 DOI: 10.1016/j.heliyon.2021.e08007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/14/2021] [Accepted: 09/13/2021] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Sensory Substitution (SS) is the use of one sensory modality to supply environmental information normally gathered by another sense while still preserving key functions of the original sense. OBJECTIVE This systematic literature review and meta-analysis summarises and synthesise current evidence and data to estimate the effectiveness of SS supplemented training for improving balance, gait and functional performance in neurological patient populations. METHODS A systematic literature search was performed in Cochrane Library, PubMed, Web of Science, and ScienceDirect. Randomized controlled trials (RCTs) using a SS training intervention were included. RESULTS Nine RCTs were included. Outcome measures/training paradigms were structured according to the balance framework of Shumway-Cook and Woollacott: Static steady-state, Dynamic steady-state and Proactive balance. Meta-analyses revealed significant overall effects of SS training for all three outcomes, as well as self-assessment and functional capacity outcomes, with Dynamic Steady-State balance and ability of stroke survivors to support bodyweight independently on paretic side lower limb found to have had the largest statistical and clinical effects. Meta-analyses also revealed non-significant retention effects. CONCLUSION This review provides evidence in favour of a global positive effect of SS training in improving Static steady-state, Dynamic steady-state and Proactive balance measures, as well as measures of self-assessment and functional capacity in neurological patient populations. Retention of effects were not significant at follow-up assessments, although no intervention met training dosage recommendations. It is important for future research to consider variables such as specific patient population, sensor type, and training modalities in order identify the most effective type of training paradigms.
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Affiliation(s)
- Peter Lynch
- Clinical Health and Nutrition Centre (CHANCE), School of Science, Institute of Technology (IT) Sligo, Ireland
- Neuroplasticity Research Group, Clinical Health and Nutrition Centre (CHANCE), School of Science, Institute of Technology (IT) Sligo, Ireland
| | - Kenneth Monaghan
- Clinical Health and Nutrition Centre (CHANCE), School of Science, Institute of Technology (IT) Sligo, Ireland
- Neuroplasticity Research Group, Clinical Health and Nutrition Centre (CHANCE), School of Science, Institute of Technology (IT) Sligo, Ireland
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Mirdamadi JL, Seigel CR, Husch SD, Block HJ. Somatotopic Specificity of Perceptual and Neurophysiological Changes Associated with Visuo-proprioceptive Realignment. Cereb Cortex 2021; 32:1184-1199. [PMID: 34424950 DOI: 10.1093/cercor/bhab280] [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: 02/16/2021] [Revised: 06/26/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
When visual and proprioceptive estimates of hand position disagree (e.g., viewing the hand underwater), the brain realigns them to reduce mismatch. This perceptual change is reflected in primary motor cortex (M1) excitability, suggesting potential relevance for hand movement. Here, we asked whether fingertip visuo-proprioceptive misalignment affects only the brain's representation of that finger (somatotopically focal), or extends to other parts of the limb that would be needed to move the misaligned finger (somatotopically broad). In Experiments 1 and 2, before and after misaligned or veridical visuo-proprioceptive training at the index finger, we used transcranial magnetic stimulation to assess M1 representation of five hand and arm muscles. The index finger representation showed an association between M1 excitability and visuo-proprioceptive realignment, as did the pinkie finger representation to a lesser extent. Forearm flexors, forearm extensors, and biceps did not show any such relationship. In Experiment 3, participants indicated their proprioceptive estimate of the fingertip, knuckle, wrist, and elbow, before and after misalignment at the fingertip. Proprioceptive realignment at the knuckle, but not the wrist or elbow, was correlated with realignment at the fingertip. These results suggest the effects of visuo-proprioceptive mismatch are somatotopically focal in both sensory and motor domains.
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Affiliation(s)
- Jasmine L Mirdamadi
- Program in Neuroscience, Indiana University Bloomington, Bloomington, IN 47405, USA.,Department of Kinesiology, School of Public Health, Indiana University Bloomington, Bloomington, IN 47405, USA
| | - Courtney R Seigel
- Program in Neuroscience, Indiana University Bloomington, Bloomington, IN 47405, USA
| | - Stephen D Husch
- Department of Kinesiology, School of Public Health, Indiana University Bloomington, Bloomington, IN 47405, USA
| | - Hannah J Block
- Program in Neuroscience, Indiana University Bloomington, Bloomington, IN 47405, USA.,Department of Kinesiology, School of Public Health, Indiana University Bloomington, Bloomington, IN 47405, USA
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12
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Riva G, Malighetti C, Serino S. Virtual reality in the treatment of eating disorders. Clin Psychol Psychother 2021; 28:477-488. [PMID: 34048622 PMCID: PMC8362149 DOI: 10.1002/cpp.2622] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/07/2021] [Accepted: 05/21/2021] [Indexed: 12/19/2022]
Abstract
Over the last 25 years, virtual reality (VR) has offered innovative solutions for targeting different key symptoms of eating disorders: from craving to negative emotions, from attentional biases to body dissatisfaction. The present narrative review assesses the existing literature in these areas trying to identify their different levels of clinical evidence. Specifically, the review presents four clinical approaches based upon VR and their implications in the treatment of eating disorders: VR cue exposure, VR reference frame shifting, VR for correcting body distortions and attentional biases. In general, existing findings demonstrate the clinical value of VR. On one side, the present review suggests that two VR-based techniques-VR exposure and reference frame shifting-have a significant research support and provide a possible advantage over traditional cognitive-behavioural therapy (CBT) for bulimia nervosa and binge eating disorder. On the other side, two emerging VR applications-multisensory body illusions and the use of VR for the modification of attentional biases-even if supported by preliminary data still need further research.
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Affiliation(s)
- Giuseppe Riva
- Applied Technology for Neuro‐Psychology Lab.Istituto Auxologico ItalianoMilanItaly
- Humane Technology Lab.Università Cattolica del Sacro CuoreMilanItaly
| | - Clelia Malighetti
- Humane Technology Lab.Università Cattolica del Sacro CuoreMilanItaly
| | - Silvia Serino
- Humane Technology Lab.Università Cattolica del Sacro CuoreMilanItaly
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Converging Robotic Technologies in Targeted Neural Rehabilitation: A Review of Emerging Solutions and Challenges. SENSORS 2021; 21:s21062084. [PMID: 33809721 PMCID: PMC8002299 DOI: 10.3390/s21062084] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 11/17/2022]
Abstract
Recent advances in the field of neural rehabilitation, facilitated through technological innovation and improved neurophysiological knowledge of impaired motor control, have opened up new research directions. Such advances increase the relevance of existing interventions, as well as allow novel methodologies and technological synergies. New approaches attempt to partially overcome long-term disability caused by spinal cord injury, using either invasive bridging technologies or noninvasive human-machine interfaces. Muscular dystrophies benefit from electromyography and novel sensors that shed light on underlying neuromotor mechanisms in people with Duchenne. Novel wearable robotics devices are being tailored to specific patient populations, such as traumatic brain injury, stroke, and amputated individuals. In addition, developments in robot-assisted rehabilitation may enhance motor learning and generate movement repetitions by decoding the brain activity of patients during therapy. This is further facilitated by artificial intelligence algorithms coupled with faster electronics. The practical impact of integrating such technologies with neural rehabilitation treatment can be substantial. They can potentially empower nontechnically trained individuals-namely, family members and professional carers-to alter the programming of neural rehabilitation robotic setups, to actively get involved and intervene promptly at the point of care. This narrative review considers existing and emerging neural rehabilitation technologies through the perspective of replacing or restoring functions, enhancing, or improving natural neural output, as well as promoting or recruiting dormant neuroplasticity. Upon conclusion, we discuss the future directions for neural rehabilitation research, diagnosis, and treatment based on the discussed technologies and their major roadblocks. This future may eventually become possible through technological evolution and convergence of mutually beneficial technologies to create hybrid solutions.
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14
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Virtual Body Ownership Illusions for Mental Health: A Narrative Review. J Clin Med 2021; 10:jcm10010139. [PMID: 33401596 PMCID: PMC7796179 DOI: 10.3390/jcm10010139] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
Over the last 20 years, virtual reality (VR) has been widely used to promote mental health in populations presenting different clinical conditions. Mental health does not refer only to the absence of psychiatric disorders but to the absence of a wide range of clinical conditions that influence people’s general and social well-being such as chronic pain, neurological disorders that lead to motor o perceptual impairments, psychological disorders that alter behaviour and social cognition, or physical conditions like eating disorders or present in amputees. It is known that an accurate perception of oneself and of the surrounding environment are both key elements to enjoy mental health and well-being, and that both can be distorted in patients suffering from the clinical conditions mentioned above. In the past few years, multiple studies have shown the effectiveness of VR to modulate such perceptual distortions of oneself and of the surrounding environment through virtual body ownership illusions. This narrative review aims to review clinical studies that have explored the manipulation of embodied virtual bodies in VR for improving mental health, and to discuss the current state of the art and the challenges for future research in the context of clinical care.
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15
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Matamala-Gomez M, Malighetti C, Cipresso P, Pedroli E, Realdon O, Mantovani F, Riva G. Changing Body Representation Through Full Body Ownership Illusions Might Foster Motor Rehabilitation Outcome in Patients With Stroke. Front Psychol 2020; 11:1962. [PMID: 32973612 PMCID: PMC7471722 DOI: 10.3389/fpsyg.2020.01962] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/15/2020] [Indexed: 12/17/2022] Open
Abstract
How our brain represents our body through the integration of internal and external sensory information so that we can interact with our surrounding environment has become a matter of interest especially in the field of neurorehabilitation. In this regard, there is an increasing interest in the use of multisensory integration techniques—such as the use of body ownership illusions—to modulate distorted body representations after brain damage. In particular, cross-modal illusions such as mirror visual feedback therapy (MVFT) have been widely used for motor rehabilitation. Despite the effectiveness of the MVFT for motor rehabilitation, there are some limitations to fully modify the distorted internal representation of the paretic limb in patients with stroke. A possible explanation for this relies on the physical limitations of the mirror in reproducing upper-limb distortions, which can result in a reduced sense of ownership of the mirrored limb. New digital technologies such as virtual reality (VR) and 360° videos allow researchers to create body ownership illusions by adapting virtual bodies so that they represent specific morphological characteristics including upper-limb distortions. In this manuscript, we present a new rehabilitation approach that employs full virtual body ownership illusions, using a 360° video system, for the assessment and modulation of the internal representation of the affected upper limb in stroke patients. We suggest modifying the internal representation of the upper limb to a normal position before starting motor rehabilitation training.
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Affiliation(s)
- Marta Matamala-Gomez
- "Riccardo Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Clelia Malighetti
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Pietro Cipresso
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, IRCCS, Milan, Italy.,Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Olivia Realdon
- "Riccardo Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Fabrizia Mantovani
- "Riccardo Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Riva
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, IRCCS, Milan, Italy
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16
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Zigiotto L, Damora A, Albini F, Casati C, Scrocco G, Mancuso M, Tesio L, Vallar G, Bolognini N. Multisensory stimulation for the rehabilitation of unilateral spatial neglect. Neuropsychol Rehabil 2020; 31:1410-1443. [PMID: 32558611 DOI: 10.1080/09602011.2020.1779754] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Unilateral spatial neglect (USN) is a neuropsychological syndrome, typically caused by lesions of the right hemisphere, whose features are the defective report of events occurring in the left (contralesional) side of space and the inability to orient and set up actions leftwards. Multisensory integration mechanisms, largely spared in USN patients, may temporally modulate spatial orienting. In this pilot study, the effects of an intensive audio-visual Multisensory Stimulation (MS) on USN were assessed, and compared with those of a treatment that ameliorates USN, Prismatic Adaptation (PA). Twenty USN stroke patients received a 2-week treatment (20 sessions, twice per day) of MS or PA. The effects of MS and PA were assessed by a set of neuropsychological clinical tests (target cancellation, line bisection, sentence reading, personal neglect, complex drawing) and the Catherine Bergego Scale for functional disability. Results showed that MS brought about an amelioration of USN deficits overall comparable to that induced by PA; personal neglect was improved only by MS, not by PA. The clinical gains of the MS treatment were not influenced by duration of disease and lesion volume, and they persisted up to one month post-treatment. In conclusion, MS represents a novel and promising rehabilitation procedure for USN.
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Affiliation(s)
- Luca Zigiotto
- Department of Psychology & Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milan, Italy.,Division of Neurosurgery, Santa Chiara Hospital, Trento, Italy
| | - Alessio Damora
- Department of Psychology & Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milan, Italy.,Tuscany Rehabilitation Clinic, Arezzo, Italy
| | - Federica Albini
- Department of Psychology & Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milan, Italy.,Clinical Neuropsychology Unit, Rehabilitation Department, S. Antonio Abate Hospital, Gallarate, Italy
| | - Carlotta Casati
- Laboratory of Neuropsychology, Istituto Auxologico Italiano, IRCCS, Milan, Italy.,Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Gessica Scrocco
- Department of Psychology & Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milan, Italy.,Tuscany Rehabilitation Clinic, Arezzo, Italy
| | - Mauro Mancuso
- Tuscany Rehabilitation Clinic, Arezzo, Italy.,Physical and Rehabilitative Medicine Unit, NHS South-Est Tuscany, Grossetto, Italy
| | - Luigi Tesio
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, Milan, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giuseppe Vallar
- Department of Psychology & Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milan, Italy.,Laboratory of Neuropsychology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Nadia Bolognini
- Department of Psychology & Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milan, Italy.,Laboratory of Neuropsychology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
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17
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Fossataro C, Bruno V, Bosso E, Chiotti V, Gindri P, Farnè A, Garbarini F. The sense of body-ownership gates cross-modal improvement of tactile extinction in brain-damaged patients. Cortex 2020; 127:94-107. [DOI: 10.1016/j.cortex.2020.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 01/17/2020] [Accepted: 02/06/2020] [Indexed: 12/11/2022]
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18
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Zhang S, Xu W, Zhu Y, Tian E, Kong W. Impaired Multisensory Integration Predisposes the Elderly People to Fall: A Systematic Review. Front Neurosci 2020; 14:411. [PMID: 32410958 PMCID: PMC7198912 DOI: 10.3389/fnins.2020.00411] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 04/06/2020] [Indexed: 11/16/2022] Open
Abstract
Background: This systematic review pooled all the latest data and reviewed all the relevant studies to look into the effect of multisensory integration on the balance function in the elderly. Methods: PubMed, Web of Science and Scopus were searched to find eligible studies published prior to May 2019. The studies were limited to those published in Chinese and English language. The quality of the included studies was assessed against the Newcastle-Ottawa Scale or an 11-item checklist, as recommended by Agency for Healthcare Research and Quality (AHRQ). Any disagreement among reviewers was resolved by comparing notes and reaching a consensus. Results: Eight hundred thirty-nine records were identified and 17 of them were included for systematic review. The result supported our assumption that multisensory integration works on balance function in the elderly. All the 17 studies were believed to be of high or moderate quality. Conclusions: The systematic review found that the impairment of multisensory integration could predispose elderly people to fall. Accurate assessment of multisensory integration can help the elderly identify the impaired balance function and minimize the risk of fall. And our results provide a new basis for further understanding of balance maintenance mechanism. Further research is warranted to explore the change in brain areas related to multisensory integration in the elderly.
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Affiliation(s)
- Sulin Zhang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenchao Xu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuting Zhu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - E Tian
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weijia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Neurological Disorders of Education Ministry, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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19
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Zink PJ, Philip BA. Cortical Plasticity in Rehabilitation for Upper Extremity Peripheral Nerve Injury: A Scoping Review. Am J Occup Ther 2020; 74:7401205030p1-7401205030p15. [PMID: 32078514 DOI: 10.5014/ajot.2020.036665] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
IMPORTANCE Poor outcomes after upper extremity peripheral nerve injury (PNI) may arise, in part, from the challenges and complexities of cortical plasticity. Occupational therapy practitioners need to understand how the brain changes after peripheral injury and how principles of cortical plasticity can be applied to improve rehabilitation for clients with PNI. OBJECTIVE To identify the mechanisms of cortical plasticity after PNI and describe how cortical plasticity can contribute to rehabilitation. DATA SOURCES PubMed and Embase (1900-2017) were searched for articles that addressed either (1) the relationship between PNI and cortical plasticity or (2) rehabilitative interventions based on cortical plastic changes after PNI. Study Selection and Data Collectio : PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Articles were selected if they addressed all of the following concepts: human PNI, cortical plasticity, and rehabilitation. Phantom limb pain and sensation were excluded. FINDINGS Sixty-three articles met the study criteria. The most common evidence level was Level V (46%). We identified four commonly studied mechanisms of cortical plasticity after PNI and the functional implications for each. We found seven rehabilitative interventions based on cortical plasticity: traditional sensory reeducation, activity-based sensory reeducation, selective deafferentation, cross-modal sensory substitution, mirror therapy, mental motor imagery, and action observation with simultaneous peripheral nerve stimulation. CONCLUSION AND RELEVANCE The seven interventions ranged from theoretically well justified (traditional and activity-based sensory reeducation) to unjustified (selective deafferentation). Overall, articles were heterogeneous and of low quality, and future research should prioritize randomized controlled trials for specific neuropathies, interventions, or cortical plasticity mechanisms. WHAT THIS ARTICLE ADDS This article reviews current knowledge about how the brain changes after PNI and how occupational therapy practitioners can take advantage of those changes for rehabilitation.
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Affiliation(s)
- Patrick J Zink
- Patrick J. Zink, MSOT, is Occupational Therapist, Select Physical Therapy, Kansas City, MO. At the time of the study, he was Student, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
| | - Benjamin A Philip
- Benjamin A. Philip, PhD, is Assistant Professor, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO;
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20
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Maccora S, Bolognini N, Cosentino G, Baschi R, Vallar G, Fierro B, Brighina F. Multisensorial Perception in Chronic Migraine and the Role of Medication Overuse. THE JOURNAL OF PAIN 2020; 21:919-929. [PMID: 31904501 DOI: 10.1016/j.jpain.2019.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 11/12/2019] [Accepted: 12/04/2019] [Indexed: 01/03/2023]
Abstract
Multisensory processing can be assessed by measuring susceptibility to crossmodal illusions such as the Sound-Induced Flash Illusion (SIFI). When a single flash is accompanied by 2 or more beeps, it is perceived as multiple flashes (fission illusion); conversely, a fusion illusion is experienced when more flashes are matched with a single beep, leading to the perception of a single flash. Such illusory perceptions are associated to crossmodal changes in visual cortical excitability. Indeed, increasing occipital cortical excitability, by means of transcranial electrical currents, disrupts the SIFI (ie, fission illusion). Similarly, a reduced fission illusion was shown in patients with episodic migraine, especially during the attack, in agreement with the pathophysiological model of cortical hyperexcitability of this disease. If episodic migraine patients present with reduced SIFI especially during the attack, we hypothesize that chronic migraine (CM) patients should consistently report less illusory effects than healthy controls; drugs intake could also affect SIFI. On such a basis, we studied the proneness to SIFI in CM patients (n = 63), including 52 patients with Medication Overuse Headache (MOH), compared to 24 healthy controls. All migraine patients showed reduced fission phenomena than controls (P < .0001). Triptan MOH patients (n = 23) presented significantly less fission effects than other CM groups (P = .008). This exploratory study suggests that CM - both with and without medication overuse - is associated to a higher visual cortical responsiveness which causes deficit of multisensorial processing, as assessed by the SIFI. PERSPECTIVE: This observational study shows reduced susceptibility to the SIFI in CM, confirming and extending previous results in episodic migraine. MOH contributes to this phenomenon, especially in case of triptans.
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Affiliation(s)
- Simona Maccora
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, Palermo, Italy
| | - Nadia Bolognini
- Department of Psychology, Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milano, Italy; Laboratory of Neuropsychology, IRCSS Istituto Auxologico, Milano, Italy
| | - Giuseppe Cosentino
- Department of Brain and Behavioural Sciences, University of Pavia, Italy; IRCCS Mondino Foundation, Pavia, Italy
| | - Roberta Baschi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, Palermo, Italy
| | - Giuseppe Vallar
- Department of Psychology, Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milano, Italy; Laboratory of Neuropsychology, IRCSS Istituto Auxologico, Milano, Italy
| | - Brigida Fierro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, Palermo, Italy
| | - Filippo Brighina
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, Palermo, Italy.
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Dilena A, Todd G, Berryman C, Rio E, Stanton TR. What is the effect of bodily illusions on corticomotoneuronal excitability? A systematic review. PLoS One 2019; 14:e0219754. [PMID: 31415588 PMCID: PMC6695177 DOI: 10.1371/journal.pone.0219754] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 07/02/2019] [Indexed: 02/07/2023] Open
Abstract
Background This systematic review aimed to summarise and critically appraise the evidence for the effect of bodily illusions on corticomotoneuronal excitability. Methods Five databases were searched, with two independent reviewers completing study inclusion, risk of bias, transcranial magnetic stimulation (TMS) reporting quality, and data extraction. Included studies evaluated the effect of an illusion that altered perception of the body (and/or its movement) on excitability of motor circuitry in healthy, adult, human participants. Studies were required to: use TMS to measure excitability and/or inhibition; report quantitative outcomes (e.g., motor evoked potentials); compare the illusion to a control or active comparison condition; evaluate that an illusion had occurred (e.g., measured illusion strength/presence). Results Of 2,257 studies identified, 11 studies (14 experiments) were included, evaluating kinaesthetic illusions (n = 5), a rubber hand illusion (RHI) paradigm (n = 5), and a missing limb illusion (n = 1). Kinaesthetic illusions (induced via vision/tendon vibration) increased corticomotoneuronal excitability. Conflicting effects were found for traditional, visuotactile RHIs of a static hand. However, embodying a hand and then observing it move (“self-action”) resulted in decreased corticomotoneuronal excitability and increased silent period duration (a measure of Gamma-Aminobutynic acid [GABA]B-mediated intracortical inhibition in motor cortex), with the opposite occurring (increased excitability, decreased inhibition) when the fake hand was not embodied prior to observing movement (“other-action”). Visuomotor illusions manipulating agency had conflicting results, but in the lower risk study, illusory agency over movement resulted in a relative decrease in corticomotoneuronal excitability. Last, an illusion of a missing limb reduced corticomotoneuronal excitability. Conclusion While evidence for the effect of bodily illusions on corticomotoneuronal excitability was limited (only 14 experiments) and had a high risk of bias, kinaesthetic illusions and illusions of embodying a hand (and seeing it move), had consistent effects. Future investigations into the role of embodiment and the illusion strength on corticomotoneuronal excitability and inhibition are warranted.
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Affiliation(s)
- Alex Dilena
- BodyinMind Research Group, School of Health Sciences, Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Gabrielle Todd
- School of Pharmacy and Medical Sciences, Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Carolyn Berryman
- BodyinMind Research Group, School of Health Sciences, Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- Neuromotor Plasticity and Development (NeuroPAD) Research Group, Robinson Research Institute, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Ebonie Rio
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Tasha R. Stanton
- BodyinMind Research Group, School of Health Sciences, Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- * E-mail:
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22
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Saleh Velez FG, Pinto CB, Bailin ES, Münger M, Ellison A, Costa BT, Crandell D, Bolognini N, Merabet LB, Fregni F. Real-time Video Projection in an MRI for Characterization of Neural Correlates Associated with Mirror Therapy for Phantom Limb Pain. J Vis Exp 2019. [PMID: 31058883 DOI: 10.3791/58800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Mirror therapy (MT) has been proposed as an effective rehabilitative strategy to alleviate pain symptoms in amputees with phantom limb pain (PLP). However, establishing the neural correlates associated with MT therapy have been challenging given that it is difficult to administer the therapy effectively within a magnetic resonance imaging (MRI) scanner environment. To characterize the functional organization of cortical regions associated with this rehabilitative strategy, we have developed a combined behavioral and functional neuroimaging protocol that can be applied in participants with a leg amputation. This novel approach allows participants to undergo MT within the MRI scanner environment by viewing real-time video images captured by a camera. The images are viewed by the participant through a system of mirrors and a monitor that the participant views while lying on the scanner bed. In this manner, functional changes in cortical areas of interest (e.g., sensorimotor cortex) can be characterized in response to the direct application of MT.
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Affiliation(s)
- Faddi G Saleh Velez
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital; University of Chicago Medical Center, Department of Neurology, University of Chicago
| | - Camila B Pinto
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital; Department of Neuroscience and Behavior, Psychology Institute, University of Sao Paulo
| | - Emma S Bailin
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School
| | - Marionna Münger
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital
| | - Andrew Ellison
- Center for Biomedical Imaging, Department of Anatomy and Neurobiology, Boston University School of Medicine
| | - Beatriz T Costa
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital
| | - David Crandell
- Spaulding Rehabilitation Hospital, Harvard Medical School
| | - Nadia Bolognini
- Department of Psychology & Milan Center for Neuroscience, University of Milano-Bicocca; Neuropsychological Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Auxologico Italiano
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School
| | - Felipe Fregni
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital;
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23
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Abstract
Paradoxical enhancement and paradoxical recovery of function after brain injury harmonize well with the concept of "ultrabilitation" and its focus on novel forms of flourishing in rehabilitation settings. I consider three sets of paradoxes which may impact on brain injury rehabilitation. Firstly, I consider post-traumatic growth after brain injury and its key determinants. Secondly, I review the role of illusions in rehabilitation and the paradox that some clinical conditions may be improved by invoking perceptual distortions. Thirdly, I consider paradoxical recovery profiles after brain injury, since knowledge of such paradoxical profiles may help inform attempts at rehabilitation of some patients. Finally, I consider how some of these paradoxes relate to components of ultrabilitation, and in addition to the nascent field of positive neuropsychology and the concept of resilience after brain injury.Implications for rehabilitationIllusions can sometimes be harnessed as a therapeutic tool in rehabilitation.There may be spontaneous, positive outcomes of an injury or illness, in the form of "post-traumatic growth", and these should be considered as part of a holistic therapeutic approach in rehabilitation.Some patients make an exceptional recovery from a severe brain insult, and lessons could be learned from such cases, such as disciplined use of compensatory strategies, which could have broader implications for neurorehabilitation.
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Affiliation(s)
- Narinder Kapur
- Research Department of Clinical Psychology, University College London, London, UK.,Imperial College Healthcare NHS Trust, London, UK.,Elysium Neurological Services, Daventry, England
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24
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Bassolino M, Franza M, Bello Ruiz J, Pinardi M, Schmidlin T, Stephan M, Solcà M, Serino A, Blanke O. Non-invasive brain stimulation of motor cortex induces embodiment when integrated with virtual reality feedback. Eur J Neurosci 2018; 47:790-799. [PMID: 29460981 PMCID: PMC5900900 DOI: 10.1111/ejn.13871] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 02/09/2018] [Accepted: 02/09/2018] [Indexed: 01/09/2023]
Abstract
Previous evidence highlighted the multisensory-motor origin of embodiment - that is, the experience of having a body and of being in control of it - and the possibility of experimentally manipulating it. For instance, an illusory feeling of embodiment towards a fake hand can be triggered by providing synchronous visuo-tactile stimulation to the hand of participants and to a fake hand or by asking participants to move their hand and observe a fake hand moving accordingly (rubber hand illusion). Here, we tested whether it is possible to manipulate embodiment not through stimulation of the participant's hand, but by directly tapping into the brain's hand representation via non-invasive brain stimulation. To this aim, we combined transcranial magnetic stimulation (TMS), to activate the hand corticospinal representation, with virtual reality (VR), to provide matching (as contrasted to non-matching) visual feedback, mimicking involuntary hand movements evoked by TMS. We show that the illusory embodiment occurred when TMS pulses were temporally matched with VR feedback, but not when TMS was administered outside primary motor cortex, (over the vertex) or when stimulating motor cortex at a lower intensity (that did not activate peripheral muscles). Behavioural (questionnaires) and neurophysiological (motor-evoked-potentials, TMS-evoked-movements) measures further indicated that embodiment was not explained by stimulation per se, but depended on the temporal coherence between TMS-induced activation of hand corticospinal representation and the virtual bodily feedback. This reveals that non-invasive brain stimulation may replace the application of external tactile hand cues and motor components related to volition, planning and anticipation.
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Affiliation(s)
- M. Bassolino
- Laboratory of Cognitive NeuroscienceBrain Mind InstituteEcole Polytechnique Fédérale de LausanneGenevaSwitzerland
- Center for NeuroprostheticsSchool of Life SciencesEcole Polytechnique Fédérale de Lausanne9 Chemin des Mines1202GenevaSwitzerland
- Center for NeuroprostheticsSchool of Life SciencesEcole Polytechnique Fédérale de LausanneClinique Romande de RéadaptationSionSwitzerland
| | - M. Franza
- Laboratory of Cognitive NeuroscienceBrain Mind InstituteEcole Polytechnique Fédérale de LausanneGenevaSwitzerland
- Center for NeuroprostheticsSchool of Life SciencesEcole Polytechnique Fédérale de Lausanne9 Chemin des Mines1202GenevaSwitzerland
- Center for NeuroprostheticsSchool of Life SciencesEcole Polytechnique Fédérale de LausanneClinique Romande de RéadaptationSionSwitzerland
| | - J. Bello Ruiz
- Laboratory of Cognitive NeuroscienceBrain Mind InstituteEcole Polytechnique Fédérale de LausanneGenevaSwitzerland
- Center for NeuroprostheticsSchool of Life SciencesEcole Polytechnique Fédérale de Lausanne9 Chemin des Mines1202GenevaSwitzerland
| | - M. Pinardi
- Laboratory of Cognitive NeuroscienceBrain Mind InstituteEcole Polytechnique Fédérale de LausanneGenevaSwitzerland
- Center for NeuroprostheticsSchool of Life SciencesEcole Polytechnique Fédérale de Lausanne9 Chemin des Mines1202GenevaSwitzerland
- Center for NeuroprostheticsSchool of Life SciencesEcole Polytechnique Fédérale de LausanneClinique Romande de RéadaptationSionSwitzerland
| | - T. Schmidlin
- Center for NeuroprostheticsSchool of Life SciencesEcole Polytechnique Fédérale de LausanneClinique Romande de RéadaptationSionSwitzerland
| | - M.A. Stephan
- Laboratory of Cognitive NeuroscienceBrain Mind InstituteEcole Polytechnique Fédérale de LausanneGenevaSwitzerland
- Center for NeuroprostheticsSchool of Life SciencesEcole Polytechnique Fédérale de Lausanne9 Chemin des Mines1202GenevaSwitzerland
| | - M. Solcà
- Laboratory of Cognitive NeuroscienceBrain Mind InstituteEcole Polytechnique Fédérale de LausanneGenevaSwitzerland
- Center for NeuroprostheticsSchool of Life SciencesEcole Polytechnique Fédérale de Lausanne9 Chemin des Mines1202GenevaSwitzerland
| | - A. Serino
- Laboratory of Cognitive NeuroscienceBrain Mind InstituteEcole Polytechnique Fédérale de LausanneGenevaSwitzerland
- Center for NeuroprostheticsSchool of Life SciencesEcole Polytechnique Fédérale de Lausanne9 Chemin des Mines1202GenevaSwitzerland
- MySpace LabDepartment of Clinical NeurosciencesUniversity Hospital Lausanne (CHUV)LausanneSwitzerland
| | - O. Blanke
- Laboratory of Cognitive NeuroscienceBrain Mind InstituteEcole Polytechnique Fédérale de LausanneGenevaSwitzerland
- Center for NeuroprostheticsSchool of Life SciencesEcole Polytechnique Fédérale de Lausanne9 Chemin des Mines1202GenevaSwitzerland
- Department of NeurologyUniversity of GenevaGenevaSwitzerland
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25
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Riva G, Dakanalis A. Altered Processing and Integration of Multisensory Bodily Representations and Signals in Eating Disorders: A Possible Path Toward the Understanding of Their Underlying Causes. Front Hum Neurosci 2018; 12:49. [PMID: 29483865 PMCID: PMC5816057 DOI: 10.3389/fnhum.2018.00049] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 01/26/2018] [Indexed: 01/25/2023] Open
Abstract
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM V) eating problems are the clinical core of eating disorders (EDs). However, the importance of shape and weight overvaluation symptoms in these disorders underlines the critical role of the experience of the body in the etiology of EDs. This article suggests that the transdiagnostic centrality of these symptoms in individuals with EDs may reflect a deficit in the processing and integration of multisensory bodily representations and signals. Multisensory body integration is a critical cognitive and perceptual process, allowing the individual to protect and extend her/his boundaries at both the homeostatic and psychological levels. To achieve this goal the brain integrates sensory data arriving from real-time multiple sensory modalities and internal bodily information with predictions made using the stored information about the body from conceptual, perceptual, and episodic memory. In this view the emotional, visual, tactile, proprioceptive and interoceptive deficits reported by many authors in individuals with EDs may reflect a broader impairment in multisensory body integration that affects the individual's abilities: (a) to identify the relevant interoceptive signals that predict potential pleasant (or aversive) consequences; and (b) to modify/correct the autobiographical allocentric (observer view) memories of body related events (self-objectified memories). Based on this view, the article also proposes a strategy, based on new technologies (i.e., virtual reality and brain/body stimulation), for using crossmodal associations to reactivate and correct the multisensory body integration processes.
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Affiliation(s)
- Giuseppe Riva
- Centro Studi e Ricerche di Psicologia della Comunicazione, Università Cattolica del Sacro Cuore, Milan, Italy
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano (IRCCS), Milan, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, Università degli Studi di Milano Bicocca, Milan, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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26
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Bolognini N, Russo C, Edwards DJ. The sensory side of post-stroke motor rehabilitation. Restor Neurol Neurosci 2018; 34:571-86. [PMID: 27080070 DOI: 10.3233/rnn-150606] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Contemporary strategies to promote motor recovery following stroke focus on repetitive voluntary movements. Although successful movement relies on efficient sensorimotor integration, functional outcomes often bias motor therapy toward motor-related impairments such as weakness, spasticity and synergies; sensory therapy and reintegration is implied, but seldom targeted. However, the planning and execution of voluntary movement requires that the brain extracts sensory information regarding body position and predicts future positions, by integrating a variety of sensory inputs with ongoing and planned motor activity. Neurological patients who have lost one or more of their senses may show profoundly affected motor functions, even if muscle strength remains unaffected. Following stroke, motor recovery can be dictated by the degree of sensory disruption. Consequently, a thorough account of sensory function might be both prognostic and prescriptive in neurorehabilitation. This review outlines the key sensory components of human voluntary movement, describes how sensory disruption can influence prognosis and expected outcomes in stroke patients, reports on current sensory-based approaches in post-stroke motor rehabilitation, and makes recommendations for optimizing rehabilitation programs based on sensory stimulation.
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Affiliation(s)
- Nadia Bolognini
- Department of Psychology and Milan Center for Neuroscience, University of Milano-Bicocca, Milano, Italy.,Laboratory of Neuropsychology, IRCCS Istituto Auxologico, Milano, Italy
| | - Cristina Russo
- Department of Psychology and Milan Center for Neuroscience, University of Milano-Bicocca, Milano, Italy
| | - Dylan J Edwards
- Burke-Cornell Medical Research Institute, White Plains, New York, NY, USA
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27
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Imaizumi S, Asai T, Koyama S. Agency over Phantom Limb Enhanced by Short-Term Mirror Therapy. Front Hum Neurosci 2017; 11:483. [PMID: 29046630 PMCID: PMC5632822 DOI: 10.3389/fnhum.2017.00483] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/19/2017] [Indexed: 12/28/2022] Open
Abstract
Most amputees experience phantom limb, whereby they feel that the amputated limb is still present. In some cases, these experiences include pain that can be alleviated by "mirror therapy." Mirror therapy consists of superimposing a mirrored image of the moving intact limb onto the phantom limb. This therapy provides a closed loop between the motor command to the amputated limb and its predicted visual feedback. This loop is also involved in the sense of agency, a feeling of controlling one's own body. However, it is unclear how mirror therapy is related to the sense of agency over a phantom limb. Using mirror therapy, we investigated phantom limb pain and the senses of agency and ownership (i.e., a feeling of having one's own body) of the phantom limb. Nine upper-limb amputees, five of whom reported recent phantom limb pain, underwent a single 15-min trial of mirror therapy. Before and after the trial, the participants completed a questionnaire regarding agency, ownership, and pain related to their phantom limb. They reported that the sense of agency over the phantom limb increased following the mirror therapy trial, while the ownership slightly increased but not as much as did the agency. The reported pain did not change; that is, it was comparably mild before and after the trial. These results suggest that short-term mirror therapy can, at least transiently, selectively enhance the sense of agency over a phantom limb, but may not alleviate phantom limb pain.
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Affiliation(s)
- Shu Imaizumi
- Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Tomohisa Asai
- Cognitive Mechanisms Laboratories, Advanced Telecommunications Research Institute International, Kyoto, Japan
| | - Shinichi Koyama
- School of Art and Design, University of Tsukuba, Tsukuba, Japan.,Graduate School of Engineering, Chiba University, Chiba, Japan
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28
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Nava E, Mattioli F, Gamberini C, Stampatori C, Bellomi F, Turati C, Capra R, Bolognini N. Altered bodily self-consciousness in multiple sclerosis. J Neuropsychol 2017; 12:463-470. [DOI: 10.1111/jnp.12134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 08/05/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Elena Nava
- Department of Psychology & NeuroMi-Milan Center for Neuroscience; University of Milan-Bicocca; Italy
| | | | - Chiara Gamberini
- Department of Psychology & NeuroMi-Milan Center for Neuroscience; University of Milan-Bicocca; Italy
| | | | - Fabio Bellomi
- Neuropsychology Unit; ASST Spedali Civili; Brescia Italy
| | - Chiara Turati
- Department of Psychology & NeuroMi-Milan Center for Neuroscience; University of Milan-Bicocca; Italy
| | | | - Nadia Bolognini
- Department of Psychology & NeuroMi-Milan Center for Neuroscience; University of Milan-Bicocca; Italy
- IRCSS Istituto Auxologico Italiano Laboratory of Neuropsychology; Milan Italy
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29
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de Dieuleveult AL, Siemonsma PC, van Erp JBF, Brouwer AM. Effects of Aging in Multisensory Integration: A Systematic Review. Front Aging Neurosci 2017; 9:80. [PMID: 28400727 PMCID: PMC5368230 DOI: 10.3389/fnagi.2017.00080] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/14/2017] [Indexed: 11/13/2022] Open
Abstract
Multisensory integration (MSI) is the integration by the brain of environmental information acquired through more than one sense. Accurate MSI has been shown to be a key component of successful aging and to be crucial for processes underlying activities of daily living (ADLs). Problems in MSI could prevent older adults (OA) to age in place and live independently. However, there is a need to know how to assess changes in MSI in individuals. This systematic review provides an overview of tests assessing the effect of age on MSI in the healthy elderly population (aged 60 years and older). A literature search was done in Scopus. Articles from the earliest records available to January 20, 2016, were eligible for inclusion if assessing effects of aging on MSI in the healthy elderly population compared to younger adults (YA). These articles were rated for risk of bias with the Newcastle-Ottawa quality assessment. Out of 307 identified research articles, 49 articles were included for final review, describing 69 tests. The review indicated that OA maximize the use of multiple sources of information in comparison to YA (20 studies). In tasks that require more cognitive function, or when participants need to adapt rapidly to a situation, or when a dual task is added to the experiment, OA have problems selecting and integrating information properly as compared to YA (19 studies). Additionally, irrelevant or wrong information (i.e., distractors) has a greater impact on OA than on YA (21 studies). OA failing to weigh sensory information properly, has not been described in previous reviews. Anatomical changes (i.e., reduction of brain volume and differences of brain areas' recruitment) and information processing changes (i.e., general cognitive slowing, inverse effectiveness, larger time window of integration, deficits in attentional control and increased noise at baseline) can only partly explain the differences between OA and YA regarding MSI. Since we have an interest in successful aging and early detection of MSI issues in the elderly population, the identified tests form a good starting point to develop a clinically useful toolkit to assess MSI in healthy OA.
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Affiliation(s)
- Alix L de Dieuleveult
- Predictive Health Technologies, Netherlands Organisation for Applied Scientific ResearchLeiden, Netherlands; Perceptual and Cognitive Systems, Netherlands Organisation for Applied Scientific ResearchSoesterberg, Netherlands
| | - Petra C Siemonsma
- Predictive Health Technologies, Netherlands Organisation for Applied Scientific ResearchLeiden, Netherlands; Thim van der Laan, University for PhysiotherapyNieuwegein, Netherlands; Faculty of Health, University of Applied Sciences LeidenLeiden, Netherlands
| | - Jan B F van Erp
- Perceptual and Cognitive Systems, Netherlands Organisation for Applied Scientific ResearchSoesterberg, Netherlands; Human Media Interaction, Electrical Engineering, Mathematics and Computer Science, University of TwenteEnschede, Netherlands
| | - Anne-Marie Brouwer
- Perceptual and Cognitive Systems, Netherlands Organisation for Applied Scientific Research Soesterberg, Netherlands
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30
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Bolognini N, Convento S, Casati C, Mancini F, Brighina F, Vallar G. Multisensory integration in hemianopia and unilateral spatial neglect: Evidence from the sound induced flash illusion. Neuropsychologia 2016; 87:134-143. [PMID: 27197073 DOI: 10.1016/j.neuropsychologia.2016.05.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/13/2016] [Accepted: 05/14/2016] [Indexed: 11/24/2022]
Abstract
Recent neuropsychological evidence suggests that acquired brain lesions can, in some instances, abolish the ability to integrate inputs from different sensory modalities, disrupting multisensory perception. We explored the ability to perceive multisensory events, in particular the integrity of audio-visual processing in the temporal domain, in brain-damaged patients with visual field defects (VFD), or with unilateral spatial neglect (USN), by assessing their sensitivity to the 'Sound-Induced Flash Illusion' (SIFI). The study yielded two key findings. Firstly, the 'fission' illusion (namely, seeing multiple flashes when a single flash is paired with multiple sounds) is reduced in both left- and right-brain-damaged patients with VFD, but not in right-brain-damaged patients with left USN. The disruption of the fission illusion is proportional to the extent of the occipital damage. Secondly, a reliable 'fusion' illusion (namely, seeing less flashes when a single sound is paired with multiple flashes) is evoked in USN patients, but neither in VFD patients nor in healthy participants. A control experiment showed that the fusion, but not the fission, illusion is lost in older participants (>50 year-old), as compared with younger healthy participants (<30 year-old). This evidence indicates that the fission and fusion illusions are dissociable multisensory phenomena, altered differently by impairments of visual perception (i.e. VFD) and spatial attention (i.e. USN). The occipital cortex represents a key cortical site for binding auditory and visual stimuli in the SIFI, while damage to right-hemisphere areas mediating spatial attention and awareness does not prevent the integration of audio-visual inputs in the temporal domain.
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Affiliation(s)
- Nadia Bolognini
- Department of Psychology, and Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milano, Italy; Laboratory of Neuropsychology, and Department of Neurorehabilitation Sciences, IRCSS Istituto Auxologico, Milano, Italy.
| | - Silvia Convento
- Department of Psychology, and Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milano, Italy; Department of Neuroscience, Baylor College of Medicine, Houston, USA
| | - Carlotta Casati
- Laboratory of Neuropsychology, and Department of Neurorehabilitation Sciences, IRCSS Istituto Auxologico, Milano, Italy
| | - Flavia Mancini
- Department of Neuroscience, Physiology & Pharmacology, University College London, London, UK
| | - Filippo Brighina
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - Giuseppe Vallar
- Department of Psychology, and Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milano, Italy; Laboratory of Neuropsychology, and Department of Neurorehabilitation Sciences, IRCSS Istituto Auxologico, Milano, Italy
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