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Motomura K, Amimoto K, Numao T, Kaneko F. Effects of a Stimulus Response Task Using Virtual Reality on Unilateral Spatial Neglect: A Randomized Controlled Trial. Arch Phys Med Rehabil 2024:S0003-9993(24)00997-3. [PMID: 38750715 DOI: 10.1016/j.apmr.2024.05.009] [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: 12/28/2023] [Revised: 04/16/2024] [Accepted: 05/07/2024] [Indexed: 06/04/2024]
Abstract
OBJECTIVE To investigate the effects of a stimulus response task using virtual reality (VR) for unilateral spatial neglect (USN). DESIGN Double-blind randomized controlled trial. SETTING Acute phase hospital where stroke patients are hospitalized. PARTICIPANTS The participants were 42 patients (N=42) with right-hemisphere cerebral damage who had been experiencing USN in their daily lives. They were randomly assigned to 3 groups: a stimulus response task with a background shift (SR+BS group), a stimulus response task without a background shift (SR group), and an object gazing task (control group). INTERVENTIONS The stimulus response task was to search for balloons that suddenly appeared on the VR screen. A background shift was added to highlight the search in the neglected space. The control task was to maintain a controlled gaze on a balloon that appeared on the VR screen. The intervention period was 5 days. MAIN OUTCOME MEASURES The primary outcome was the participants' scores on a stimulus-driven attention test (SAT) using the reaction time. The stimuli of the SAT were divided into 6 blocks of 3 lines on each side (-3 to +3). The secondary outcomes were their scores on the Behavioral Intention Test conventional, Catherine Bergego Scale, and straight ahead pointing tests. RESULTS In the SAT, there were significant interaction effects of reaction time between time and group factors in left-2, right+2, and right+3. The SR+BS and SR groups showed significant improvements in the reaction time of left-2 and right+3 compared with the control group. Moreover, the SR+BS group showed a significant improvement in the reaction time of left-2, which was the neglected space, compared with the SR group. However, there were no significant interaction effects of Behavioral Intention Test conventional, Catherine Bergego Scale, and straight ahead pointing. CONCLUSIONS Our results suggest that the use of stimulus response tasks using VR combined with background shifts may improve left-sided USN.
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Affiliation(s)
- Kazuya Motomura
- Department of Rehabilitation, Mishuku Hospital, Meguro, Tokyo, Japan; Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.
| | - Kazu Amimoto
- Department of Rehabilitation Sciences, Sendai Seiyo Gakuin College, Sendai, Miyagi, Japan
| | - Taku Numao
- Department of Physical Therapy, Japanese School of Technology for Social Medicine, Koganei, Tokyo, Japan
| | - Fuminari Kaneko
- Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Stammler B, Flammer K, Schuster T, Lambert M, Neumann O, Lux M, Matuz T, Karnath HO. Spatial Neglect Therapy With the Augmented Reality App "Negami" for Active Exploration Training: A Randomized Controlled Trial on 20 Stroke Patients With Spatial Neglect. Arch Phys Med Rehabil 2023; 104:1987-1994. [PMID: 37582475 DOI: 10.1016/j.apmr.2023.07.017] [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: 03/24/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVE To investigate the efficacy of the augmented reality (AR) app "Negami" as an active exploration training for the treatment of spatial neglect. Improvements of the ipsilesional attention and orientation bias (and resulting contralesional neglect) will be examined in stroke patients with spatial neglect and compared with a control group. DESIGN Randomized controlled trial with an experimental Negami group, consisting of patients with spatial neglect, and a group of neglect patients receiving standard neglect therapy. SETTING Three rehabilitation hospitals. PARTICIPANTS Twenty right hemispheric stroke patients with spatial neglect (N=20). INTERVENTION Over a period of 2 weeks, both groups received 5 training sessions per week (à 25 minutes). Neglect behavior was assessed weekly over a 5-week period, with the Negami therapy group receiving a second follow-up assessment at 1-to-2-month intervals after completion of training. MAIN OUTCOME MEASURES Letter Cancellation, Bells Test, Copying Task, Line Bisection Task, and a self-developed "Exploration Test". RESULTS Both groups improved significantly. While the Negami therapy group improved in 4 of 5 neglect tests used, the standard therapy group improved in only 1 of these tests. We observed significantly better improvement in the Negami group already after the first week of training. This difference was also significant after the end of the training as well as 1 week after the end of training and remained stable 1-2 months after the end of treatment. CONCLUSION Negami can be used as an effective alternative or addition to current standard neglect therapy, and may even be superior to it.
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Affiliation(s)
- Britta Stammler
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | | | | | | | | | - Michael Lux
- Neurological Rehabilitation Center Quellenhof, Sana Kliniken AG, Bad Wildbad, Germany
| | - Tamara Matuz
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; Kreiskliniken Reutlingen, Reutlingen, Germany
| | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
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Davide E, Jenifer M, Alessia T, Alberto M, Monica G. Young children can use their subjective straight-ahead to remap visuo-motor alterations. Sci Rep 2023; 13:6427. [PMID: 37081091 PMCID: PMC10119127 DOI: 10.1038/s41598-023-33127-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 04/07/2023] [Indexed: 04/22/2023] Open
Abstract
Young children and adults process spatial information differently: the former use their bodies as primary reference, while adults seem capable of using abstract frames. The transition is estimated to occur between the 6th and the 12th year of age. The mechanisms underlying spatial encoding in children and adults are unclear, as well as those underlying the transition. Here, we investigated the role of the subjective straight-ahead (SSA), the body antero-posterior half-plane mental model, in spatial encoding before and after the expected transition. We tested 6-7-year-old and 10-11-year-old children, and adults on a spatial alignment task in virtual reality, searching for differences in performance when targets were placed frontally or sideways. The performance differences were assessed both in a naturalistic baseline condition and in a test condition that discouraged using body-centered coordinates through a head-related visuo-motor conflict. We found no differences in the baseline condition, while all groups showed differences between central and lateral targets (SSA effect) in the visuo-motor conflict condition, and 6-7-year-old children showed the largest effect. These results confirm the expected transition timing; moreover, they suggest that children can abstract from the body using their SSA and that the transition underlies the maturation of a world-centered reference frame.
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Affiliation(s)
- Esposito Davide
- Unit for Visually Impaired People, Fondazione Istituto Italiano di Tecnologia, 16163, Genova, Italy.
| | - Miehlbradt Jenifer
- Bertarelli Foundation Chair in Translational Neuroengineering, EPFL, 1015, Lausanne, Switzerland
| | - Tonelli Alessia
- Unit for Visually Impaired People, Fondazione Istituto Italiano di Tecnologia, 16163, Genova, Italy
| | - Mazzoni Alberto
- The Biorobotics Institute, Scuola Superiore Sant'Anna, 56127, Pontedera, Italy
| | - Gori Monica
- Unit for Visually Impaired People, Fondazione Istituto Italiano di Tecnologia, 16163, Genova, Italy
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Kirollos R, Herdman CM. Caloric vestibular stimulation induces vestibular circular vection even with a conflicting visual display presented in a virtual reality headset. Iperception 2023; 14:20416695231168093. [PMID: 37113619 PMCID: PMC10126621 DOI: 10.1177/20416695231168093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/06/2023] [Indexed: 04/29/2023] Open
Abstract
This study explored visual-vestibular sensory integration when the vestibular system receives self-motion information using caloric irrigation. The objectives of this study were to (1) determine if measurable vestibular circular vection can be induced in healthy participants using caloric vestibular stimulation and (2) determine if a conflicting visual display could impact vestibular vection. In Experiment 1 (E1), participants had their eyes closed. Air caloric vestibular stimulation cooled the endolymph fluid of the horizontal semi-circular canal inducing vestibular circular vection. Participants reported vestibular circular vection with a potentiometer knob that measured circular vection direction, speed, and duration. In Experiment 2 (E2), participants viewed a stationary display in a virtual reality headset that did not signal self-motion while receiving caloric vestibular stimulation. This produced a visual-vestibular conflict. Participants indicated clockwise vection in the left ear and counter-clockwise vection in right ear in a significant proportion of trials in E1 and E2. Vection was significantly slower and shorter in E2 compared to E1. E2 results demonstrated that during visual-vestibular conflict, visual and vestibular cues are used to determine self-motion rather than one system overriding the other. These results are consistent with optimal cue integration hypothesis.
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Affiliation(s)
- Ramy Kirollos
- Ramy Kirollos, Defence Research and Development
Canada, Toronto Research Center, 1133 Sheppard Ave. W., Toronto, Ontario, M3 K 2C9,
Canada; Visualization and Simulation Center, Carleton University, 1125 Colonel By Drive,
Ottawa, Ontario, K1S 5B6, Canada.
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Wiesen D, Bonilha L, Rorden C, Karnath HO. Disconnectomics to unravel the network underlying deficits of spatial exploration and attention. Sci Rep 2022; 12:22315. [PMID: 36566307 PMCID: PMC9789971 DOI: 10.1038/s41598-022-26491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/15/2022] [Indexed: 12/25/2022] Open
Abstract
Spatial attention and exploration are related to a predominantly right hemispheric network structure. However, the areas of the brain involved and their exact role is still debated. Spatial neglect following right hemispheric stroke lesions has been frequently viewed as a model to study these processes in humans. Previous investigations on the anatomical basis on spatial neglect predominantly focused on focal brain damage and lesion-behaviour mapping analyses. This approach might not be suited to detect remote areas structurally spared but which might contribute to the behavioural deficit. In the present study of a sample of 203 right hemispheric stroke patients, we combined connectome lesion-symptom mapping with multivariate support vector regression to unravel the complex and disconnected network structure in spatial neglect. We delineated three central nodes that were extensively disconnected from other intrahemispheric areas, namely the right superior parietal lobule, the insula, and the temporal pole. Additionally, the analysis allocated central roles within this network to the inferior frontal gyrus (pars triangularis and opercularis), right middle temporal gyrus, right temporal pole and left and right orbitofrontal cortices, including interhemispheric disconnection. Our results suggest that these structures-although not necessarily directly damaged-might play a role within the network underlying spatial neglect in humans.
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Affiliation(s)
- Daniel Wiesen
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany.
| | | | | | - Hans-Otto Karnath
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany
- Department of Psychology, University of South Carolina, Columbia, USA
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Choi HS, Lee BM. A Complex Intervention Integrating Prism Adaptation and Neck Vibration for Unilateral Neglect in Patients of Chronic Stroke: A Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13479. [PMID: 36294062 PMCID: PMC9603544 DOI: 10.3390/ijerph192013479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/06/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Unilateral neglect in patients of chronic stroke reduces the quality of life and interferes with activities of daily living (ADL). This study aimed to investigate the effects of a complex rehabilitative programme that integrates prism adaptation (PA) and neck vibration (NV) for unilateral neglect in patients of chronic stroke. Thirty-six patients were randomised among the PA + NV group (Group A, n = 12), the NV-only group (Group B, n = 12), and the PA-only group (Group C, n = 12). The intervention was performed for 50 min/day, with five sessions per week, for 4 weeks. Albert's test and the Catherine Bergego Scale were used to measure the effects of each intervention on unilateral neglect, whereas the modified Barthel Index was used to assess the effect on ADL. All three groups exhibited a reduction in unilateral neglect and an improvement in activities of daily living after the intervention (p < 0.05). Notably, Group A (PA + NV) exhibited a significantly greater level of reduction in unilateral neglect than the other groups (p < 0.05); however, the improvement in ADL did not significantly vary across the three groups (p > 0.05). This novel complex intervention comprising PA + NV is recommended for the rehabilitation, in the clinical setting, of patients of chronic stroke with unilateral neglect.
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Affiliation(s)
- Hyun-Se Choi
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Bo-Min Lee
- Department of Rehabilitation Science, Inje University Graduate School, Gimhae 50834, Korea
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7
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Sim TY, Kwon JS. Comparing the effectiveness of bimanual and unimanual mirror therapy in unilateral neglect after stroke: A pilot study. NeuroRehabilitation 2021; 50:133-141. [PMID: 34957959 DOI: 10.3233/nre-210233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Unilateral neglect in stroke patients is a major obstacle to rehabilitation, which is a great challenge for therapists. OBJECTIVE This study aimed to compare the effectiveness of bimanual mirror therapy (BMT) and unimanual mirror therapy (UMT), the two protocols of mirror therapy, for the reduction of the symptoms of unilateral neglect in stroke patients. METHODS Twenty-eight individuals were randomly assigned to the UMT or BMT groups. Both groups received mirror therapy for 30 minutes per day, 5 days a week, for a period of 4 weeks. The Star Cancelation Test (SCT), Line Bisection Test (LBT), Picture Scanning test (PST), and Korean Catherine Bergego Scale (K-CBS) were used to measure the change in unilateral neglect, and the Korean version of the Modified Barthel Index (K-MBI) was used to evaluate activities of daily living (ADL). RESULTS The results of SCT, LBT, PST, and K-CBS showed significant decreases in unilateral neglect in both groups (p < 0.05). K-MBI improved significantly in both groups (p < 0.05). There were significant differences between the two groups in the unilateral neglect tests (p < 0.05), but no significant difference in ADL evaluation (p > 0.05). CONCLUSIONS Mirror therapy protocols can be applied to treat unilateral neglect in stroke patients. However, BMT may be more beneficial for reducing the symptoms of unilateral neglect.
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Affiliation(s)
- Tae Yong Sim
- Department of Occupational Therapy, Cheongju St. Mary's Hospital, Cheongju, Republic of Korea
| | - Jae Sung Kwon
- Department of Occupational Therapy, College of Health Science, Cheongju University, Cheongju, Republic of Korea
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8
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Halicka M, Vittersø AD, Proulx MJ, Bultitude JH. Attention upturned: Bias toward and away from the affected side of the body and near space in a case of complex regional pain syndrome. Neuropsychologia 2021; 163:108079. [PMID: 34740614 DOI: 10.1016/j.neuropsychologia.2021.108079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/24/2021] [Accepted: 10/29/2021] [Indexed: 10/19/2022]
Abstract
People with Complex Regional Pain Syndrome (CRPS) following limb injury can show neuropsychological symptoms in the absence of observable brain pathologies. These can include sensory changes, distorted body representation, and inattention to their affected limb and its surrounding space, resembling post-stroke hemispatial neglect. The precise nature and mechanisms of these neuropsychological symptoms are unclear, however insights could be gained by testing for dissociations and associations that have been observed in stroke patients. Drawing from clinical and experimental methods for investigating spatial attention bias and related symptoms in stroke patients, we conducted a detailed investigation of neuropsychological symptoms in a woman with CRPS of her left arm who initially presented to us with pronounced inattention to her affected side. The patient showed visual and tactile neglect and extinction on her affected side on confrontation tests, but no attention deficits on "bedside" tests of neglect. On sensitive computer-based measures, attention biases were found in the patient's body and near space (in Temporal Order Judgements), but not far or imagined space (on the Greyscales task and Mental Number Line Bisection). Unique to the current literature, the patient showed a reversal in her Temporal Order Judgement bias across time, from inattention (first and second session) to hyperattention (third session) to her affected side. In contrast, pain and self-reported body representation distortion were similar across the three sessions. The patient had reduced central and peripheral visual acuity, however these deficits were near symmetrical and therefore could not explain her performance on the visual attention tasks. Given that spatial attention bias has been linked to imbalance in relative activation of the two cerebral hemispheres, we administered a Global-Local processing task to test for hemispheric asymmetry. This revealed no difference in global compared to local interference refuting any hemispheric imbalance. Instead, the patient showed impaired performance (compared to controls) on incongruent trials regardless of trial type, consistent with executive impairment. We conclude that spatial attention bias in CRPS can generalize across different sensory modalities and extend beyond the affected limb to the external space around it, independent of any low-level sensory disturbances. This bias is not necessarily directed away from the affected side or stable over time. People with CRPS can also demonstrate more generalized neuropsychological changes in sensory and executive functions. Our observations refute several existing theories about the mechanisms of attention bias in CRPS, and their relationship to pain, and have potential implications for treatment.
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Affiliation(s)
- Monika Halicka
- Centre for Pain Research, University of Bath, Bath, United Kingdom; Department of Psychology, University of Bath, Bath, United Kingdom.
| | - Axel D Vittersø
- Centre for Pain Research, University of Bath, Bath, United Kingdom; Department of Psychology, University of Bath, Bath, United Kingdom; Department of Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
| | - Michael J Proulx
- Department of Psychology, University of Bath, Bath, United Kingdom; Centre for Reality & Virtual Environments Augmentation Labs, Department of Computer Science, University of Bath, Bath, United Kingdom
| | - Janet H Bultitude
- Centre for Pain Research, University of Bath, Bath, United Kingdom; Department of Psychology, University of Bath, Bath, United Kingdom; Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, Oxford, United Kingdom
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9
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Turgut N, Jansen AL, Nielsen J, Heber I, Eling P, Hildebrandt H. Repeated application of the covert shift of attention task improves endogenous but not exogenous attention in patients with unilateral visuospatial inattention. Brain Cogn 2021; 151:105732. [PMID: 33895466 DOI: 10.1016/j.bandc.2021.105732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/04/2021] [Accepted: 04/06/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Most neglect treatment studies focus on automatic re-orientation procedures, assuming a deficit in automatic processes. We compare an automatic- and a controlled procedure, using the endogenous and exogenous variants of Posner's covert shift of attention task. METHOD In two experiments, neglect patients and patients with a right hemispherical stroke without neglect performed three blocks of Posner's covert shift of attention task (Posner Task) on two days. In Study 1 we used endogenous cues, in Study 2, exogenous cues. RESULTS In the endogenous task, neglect patients improved significantly with valid left-sided cues between block 1 and 2 on Day 1, subsequently showing a plateauing. They also showed a gradual improvement on invalid trials on both days. In the exogenous condition, all participants responded only increasingly faster on trials with a long stimulus onset asynchrony. Practicing on both tasks led to fewer omissions for left-sided targets, minimally in the exogenous and clearly in the endogenous condition. CONCLUSION In line with prior neuroanatomical studies, our study shows that practicing an endogenous, but not an exogenous, visuospatial attention task leads to significant improvements in neglect patients, especially for invalid trials, suggesting that neglect treatments based on top-down strategies should be given more attention.
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Affiliation(s)
- Nergiz Turgut
- Instituto de Neurociencias, Universidad San Francisco de Quito, Quito, Ecuador
| | - Anna-Lena Jansen
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
| | - Jörn Nielsen
- Department of Cognitive Rehabilitation, Neurological Rehabilitation Centre Godeshöhe, Bonn, Germany; Department of Medical Psychology
- Neuropsychology and Gender Studies, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Ines Heber
- Department of Neurological Rehabilitation, Median Klinik Wilhelmshaven, Wilhelmshaven, Germany
| | - Paul Eling
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, the Netherlands
| | - Helmut Hildebrandt
- Department of Psychology, University of Oldenburg, Oldenburg, Germany; Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany.
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Occhigrossi C, Brosch M, Giommetti G, Panichi R, Ricci G, Ferraresi A, Roscini M, Pettorossi VE, Faralli M. Auditory perception is influenced by the orientation of the trunk relative to a sound source. Exp Brain Res 2021; 239:1223-1234. [PMID: 33587165 DOI: 10.1007/s00221-021-06047-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 01/18/2021] [Indexed: 12/15/2022]
Abstract
The study investigated how hearing depends on the whole body, head and trunk orientation relative to a sound source. In normal hearing humans we examined auditory thresholds and their ability to recognize logatomes (bi-syllabic non-sense words) at different whole body, head and trunk rotation relative to a sound source. We found that auditory threshold was increased and logatome recognition was impaired when the body or the trunk were rotated 40° away from a sound source compared to when the body or the trunk was oriented towards the sound source. Conversely, no effects were seen when only the head was rotated. Further, an increase of thresholds and impairment of logatome recognition were also observed after unilateral vibration of dorsal neck muscles that induces, per se, long-lasting illusory trunk displacement relative to the head. Thus, our findings support the idea that processing of acoustic signals depends on where a sound is located within a reference system defined by the subject's trunk coordinates.
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Affiliation(s)
- Chiara Occhigrossi
- Department of Experimental Medicine, Human Physiology Section, Università degli Studi di Perugia, Perugia, Italy
| | - Michael Brosch
- Research Group Comparative Neuroscience, Leibniz Institute for Neurobiology, Brenneckestraße 6, 39118, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Otto-Von-Guericke-University, Universitätsplatz 2, 39106, Magdeburg, Germany
| | - Giorgia Giommetti
- Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Perugia, Italy
| | - Roberto Panichi
- Department of Experimental Medicine, Human Physiology Section, Università degli Studi di Perugia, Perugia, Italy
| | - Giampietro Ricci
- Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Perugia, Italy
| | - Aldo Ferraresi
- Department of Experimental Medicine, Human Physiology Section, Università degli Studi di Perugia, Perugia, Italy
| | - Mauro Roscini
- Department of Experimental Medicine, Human Physiology Section, Università degli Studi di Perugia, Perugia, Italy
| | - Vito Enrico Pettorossi
- Department of Experimental Medicine, Human Physiology Section, Università degli Studi di Perugia, Perugia, Italy.
| | - Mario Faralli
- Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Perugia, Italy
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The effects of neck muscle vibration on postural orientation and spatial perception: A systematic review. Neurophysiol Clin 2020; 50:227-267. [DOI: 10.1016/j.neucli.2019.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 10/06/2019] [Accepted: 10/06/2019] [Indexed: 11/17/2022] Open
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Machner B, Lencer MC, Möller L, von der Gablentz J, Heide W, Helmchen C, Sprenger A. Unbalancing the Attentional Priority Map via Gaze-Contingent Displays Induces Neglect-Like Visual Exploration. Front Hum Neurosci 2020; 14:41. [PMID: 32153377 PMCID: PMC7045871 DOI: 10.3389/fnhum.2020.00041] [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: 12/10/2019] [Accepted: 01/27/2020] [Indexed: 11/15/2022] Open
Abstract
Selective spatial attention is a crucial cognitive process that guides us to the behaviorally relevant objects in a complex visual world by using exploratory eye movements. The spatial location of objects, their (bottom-up) saliency and (top-down) relevance is assumed to be encoded in one “attentional priority map” in the brain, using different egocentric (eye-, head- and trunk-centered) spatial reference frames. In patients with hemispatial neglect, this map is supposed to be imbalanced, leading to a spatially biased exploration of the visual environment. As a proof of concept, we altered the visual saliency (and thereby attentional priority) of objects in a naturalistic scene along a left-right spatial gradient and investigated whether this can induce a bias in the exploratory eye movements of healthy humans (n = 28; all right-handed; mean age: 23 years, range 19–48). We developed a computerized mask, using high-end “gaze-contingent display (GCD)” technology, that immediately and continuously reduced the saliency of objects on the left—“left” with respect to the head (body-centered) and the current position on the retina (eye-centered). In both experimental conditions, task-free viewing and goal-driven visual search, this modification induced a mild but significant bias in visual exploration similar to hemispatial neglect. Accordingly, global eye movement parameters changed (reduced number and increased duration of fixations) and the spatial distribution of fixations indicated an attentional bias towards the right (rightward shift of first orienting, fixations favoring the scene’s outmost right over left). Our results support the concept of an attentional priority map in the brain as an interface between perception and behavior and as one pathophysiological ground of hemispatial neglect.
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Affiliation(s)
- Björn Machner
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Marie C Lencer
- Department of Psychology II, University of Lübeck, Lübeck, Germany
| | - Lisa Möller
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | | | - Wolfgang Heide
- Department of Neurology, General Hospital Celle, Celle, Germany
| | | | - Andreas Sprenger
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Department of Psychology II, University of Lübeck, Lübeck, Germany
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Lucente G, Valls-Sole J, Murillo N, Rothwell J, Coll J, Davalos A, Kumru H. Noninvasive Brain Stimulation and Noninvasive Peripheral Stimulation for Neglect Syndrome Following Acquired Brain Injury. Neuromodulation 2019; 23:312-323. [PMID: 31725939 DOI: 10.1111/ner.13062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/10/2019] [Accepted: 09/10/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Hemispatial neglect is a frequent condition usually following nondominant hemispheric brain injury. It strongly affects rehabilitation strategies and everyday life activities. It is associated with behavioral and cognitive disability with a strong impact on patient's life. METHODS We reviewed the published literature on the use of noninvasive brain stimulation, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), and of noninvasive peripheral muscle stimulation, as therapeutic strategies for rehabilitation of neglect after acquired brain injury, such as in stroke or in traumatic injuries. The studies were grouped as controlled or uncontrolled studies in each stimulation techniques. RESULTS Thirty-four studies were identified and 16 on rTMS, 10 on tDCS, and 8 on vibration. All studies were conducted in adult patients who suffered a stroke, except for one that was conducted in a patient suffering traumatic acquired brain injury and another that was conducted in a patient with brain tumor. In spite of significant variability in treatment protocols, patients' features and assessment of neglect, improvement was reported in almost all studies with no side-effects. CONCLUSIONS Noninvasive brain stimulation and neuromuscular vibration are promising therapeutic neuromodulatory approaches for neglect. Further randomized-controlled studies are needed to corroborate their effectiveness as separate and combined techniques.
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Affiliation(s)
- Giuseppe Lucente
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Spain.,Grup de Recerca en Malalties Neuromusculars i Neuropediatriques, Department of Neurosciences, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Josep Valls-Sole
- EMG Department, Hospital Clinic, Carrer de Villarroel, 170, 08036 Barcelona, Spain
| | - Narda Murillo
- Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain.,Fundación Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, 08916, Badalona, Spain
| | - John Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, University College London, London, UK
| | - Jaume Coll
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Spain.,Grup de Recerca en Malalties Neuromusculars i Neuropediatriques, Department of Neurosciences, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Antoni Davalos
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Spain.,Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Hatice Kumru
- Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundación Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, 08916, Badalona, Spain
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14
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Paschke K, Bähr M, Wüstenberg T, Wilke M. Trunk rotation and handedness modulate cortical activation in neglect-associated regions during temporal order judgments. NEUROIMAGE-CLINICAL 2019; 23:101898. [PMID: 31491819 PMCID: PMC6627032 DOI: 10.1016/j.nicl.2019.101898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 05/13/2019] [Accepted: 06/13/2019] [Indexed: 12/02/2022]
Abstract
The rotation of the trunk around its vertical midline could be shown to bias visuospatial temporal judgments towards targets in the hemifield ipsilateral to the trunk orientation and to improve visuospatial performance in patients with visual neglect. However, the underlying brain mechanisms are not well understood. Therefore, the goal of the present study was to investigate the neural effects associated with egocentric midplane shifts under consideration of individual handedness. We employed a visuospatial temporal order judgment (TOJ) task in healthy right- and left-handed subjects while their trunk rotation was varied. Participants responded by a saccade towards the stimulus perceived first out of two stimuli presented with different stimulus onset asynchronies (SOA). Apart from gaze behavior, BOLD-fMRI responses were measured using functional magnetic resonance imaging (fMRI). Based on findings from spatial neglect research, analyses of fMRI-BOLD responses were focused on a bilateral fronto-temporo-parietal network comprising Brodmann areas 22, 39, 40, and 44, as well as the basal ganglia core nuclei (caudate, putamen, pallidum). We observed an acceleration of saccadic speed towards stimuli ipsilateral to the trunk orientation modulated by individual handedness. Left-handed participants showed the strongest behavioral and neural effects, suggesting greater susceptibility to manipulations of trunk orientation. With respect to the dominant hand, a rotation around the vertical trunk midline modulated the activation of an ipsilateral network comprising fronto-temporo-parietal regions and the putamen with the strongest effects for saccades towards the hemifield opposite to the dominant hand. Within the investigated network, the temporo-parietal junction (TPJ) appears to serve as a region integrating sensory, motor, and trunk position information. Our results are discussed in the context of gain modulatory and laterality effects. We examined the effect of trunk rotation on brain responses in neglect-associated areas.Trunk-related BOLD-fMRI activation patterns depend on handedness. They were modulated most during trunk rotation contralateral to the dominant hand. Trunk rotation and saccade direction show interaction effects at TPJ. TPJ serves as a region integrating sensory, motor, and trunk position information.
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Affiliation(s)
- Kerstin Paschke
- Department of Cognitive Neurology, University Medicine Göttingen, Robert-Koch-Str. 40, Göttingen 37075, Germany; German Center for Addiction Research in Childhood and Adolescence, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany; Department of Neurology, University Medicine Göttingen, Robert-Koch-Str. 40, Goettingen 37075, Germany.
| | - Mathias Bähr
- Department of Neurology, University Medicine Göttingen, Robert-Koch-Str. 40, Goettingen 37075, Germany; DFG Center for Nanoscale Microscopy & Molecular Physiology of the Brain (CNMPB), Germany
| | - Torsten Wüstenberg
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Charité Campus Mitte, Charitéplatz 1, Berlin 10117, Germany; Systems Neuroscience in Psychiatry (SNiP), Central Institute of Mental Health, Mannheim, J5, Mannheim 68159, Germany
| | - Melanie Wilke
- Department of Cognitive Neurology, University Medicine Göttingen, Robert-Koch-Str. 40, Göttingen 37075, Germany; DFG Center for Nanoscale Microscopy & Molecular Physiology of the Brain (CNMPB), Germany; German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, Göttingen 37077, Germany; Leibniz-science campus primate cognition, Germany
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15
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Karnath HO, Kriechel I, Tesch J, Mohler BJ, Mölbert SC. Caloric vestibular stimulation has no effect on perceived body size. Sci Rep 2019; 9:11411. [PMID: 31388079 PMCID: PMC6684593 DOI: 10.1038/s41598-019-47897-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/25/2019] [Indexed: 12/04/2022] Open
Abstract
It has been suggested that the vestibular system not only plays a role for our sense of balance and postural control but also might modulate higher-order body representations, such as the perceived shape and size of our body. Recent findings using virtual reality (VR) to realistically manipulate the length of whole extremities of first person biometric avatars under vestibular stimulation did not support this assumption. It has been discussed that these negative findings were due to the availability of visual feedback on the subjects' virtual arms and legs. The present study tested this hypothesis by excluding the latter information. A newly recruited group of healthy subjects had to adjust the position of blocks in 3D space of a VR scenario such that they had the feeling that they could just touch them with their left/right hand/heel. Caloric vestibular stimulation did not alter perceived size of own extremities. Findings suggest that vestibular signals do not serve to scale the internal representation of (large parts of) our body's metric properties. This is in obvious contrast to the egocentric representation of our body midline which allows us to perceive and adjust the position of our body with respect to the surroundings. These two qualia appear to belong to different systems of body representation in humans.
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Affiliation(s)
- Hans-Otto Karnath
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
- Department of Psychology, University of South Carolina, Columbia, SC, 29208, USA.
| | - Isabel Kriechel
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Joachim Tesch
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Betty J Mohler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Technical University Darmstadt, Institute of Sports Science, Darmstadt, Germany
| | - Simone Claire Mölbert
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Medical University Hospital Tübingen, Dept. of Psychosomatic Medicine and Psychotherapy, University of Tübingen, Tübingen, Germany
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16
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Labreche T, Wild B, Dalton K, Leat SJ. Post-stroke visual midline shift syndrome. Clin Exp Optom 2019; 103:290-295. [PMID: 31321827 DOI: 10.1111/cxo.12944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 03/13/2019] [Accepted: 06/24/2019] [Indexed: 11/27/2022] Open
Abstract
The state of research on the topic of visual midline shift syndrome following a cerebrovascular accident is unknown. A scoping review was conducted using the search terms of 'visual midline shift' (or equivalent) and 'cerebrovascular accident' (or equivalent). Articles were selected from eight academic and one grey literature database, and went through two levels of review, as per Arksey and O'Malley, before being deemed acceptable for inclusion. Of the 931 abstracts reviewed, 27 articles met the criteria for inclusion. Data extracted from the selected articles included terminology and definition, symptoms, underlying pathophysiology, duration, assessment method, and management of visual midline shift syndrome following cerebrovascular accident. There is agreement on the existence of a midline shift following a cerebrovascular accident resulting in poor posture and imbalance. Much uncertainty exists in the literature regarding terminology, underlying pathophysiology, assessment method and management of this condition. Further research is required.
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Affiliation(s)
- Tammy Labreche
- Waterloo School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - Benjamin Wild
- Waterloo School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - Kristine Dalton
- Waterloo School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - Susan J Leat
- Waterloo School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
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17
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Podokinetic After-Rotation Is Transiently Enhanced or Reversed by Unilateral Axial Muscle Proprioceptive Stimulation. Neural Plast 2019; 2019:7129279. [PMID: 30984256 PMCID: PMC6432728 DOI: 10.1155/2019/7129279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 12/11/2018] [Indexed: 12/25/2022] Open
Abstract
Unilateral axial muscle vibration, eliciting a proprioceptive volley, is known to incite steering behavior. Whole-body rotation while stepping in place also occurs as an after-effect of stepping on a circular treadmill (podokinetic after-rotation, PKAR). Here, we tested the hypothesis that PKAR is modulated by axial muscle vibration. If both phenomena operate through a common pathway, enhancement or cancellation of body rotation would occur depending on the stimulated side when vibration is administered concurrently with PKAR. Seventeen subjects participated in the study. In one session, subjects stepped in place eyes open on the center of a platform that rotated counterclockwise 60°/s for 10 min. When the platform stopped, subjects continued stepping in place blindfolded. In other session, a vibratory stimulus (100 Hz, 2 min) was administered to right or left paravertebral muscles at lumbar level at two intervals during the PKAR. We computed angular body velocity and foot step angles from markers fixed to shoulders and feet. During PKAR, all subjects rotated clockwise. Decreased angular velocity was induced by right vibration. Conversely, when vibration was administered to the left, clockwise rotation velocity increased. The combined effect on body rotation depended on the time at which vibration was administered during PKAR. Under all conditions, foot step angle was coherent with shoulder angular velocity. PKAR results from continuous asymmetric input from the muscles producing leg rotation, while axial muscle vibration elicits a proprioceptive asymmetric input. Both conditioning procedures appear to produce their effects through a common mechanism. We suggest that both stimulations would affect our straight ahead by combining their effects in an algebraic mode.
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18
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Turgut N, Möller L, Dengler K, Steinberg K, Sprenger A, Eling P, Kastrup A, Hildebrandt H. Adaptive Cueing Treatment of Neglect in Stroke Patients Leads to Improvements in Activities of Daily Living: A Randomized Controlled, Crossover Trial. Neurorehabil Neural Repair 2018; 32:988-998. [DOI: 10.1177/1545968318807054] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Nergiz Turgut
- Klinikum Bremen-Ost, Bremen, Germany
- Carl von Ossietzky Universität Oldenburg, Germany
| | | | | | | | - Andreas Sprenger
- University Hospital of Schleswig Holstein-Campus Lübeck, Germany
| | - Paul Eling
- Radboud University Nijmegen, Netherlands
| | | | - Helmut Hildebrandt
- Klinikum Bremen-Ost, Bremen, Germany
- Carl von Ossietzky Universität Oldenburg, Germany
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19
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Ceyte H, Beis JM, Simon M, Rémy A, Anxionnat R, Paysant J, Caudron S. Lasting improvements in left spatial neglect following a protocol combining neck-muscle vibration and voluntary arm movements: a case-study. Disabil Rehabil 2018; 41:1475-1483. [DOI: 10.1080/09638288.2018.1430178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Hadrien Ceyte
- Development, Adaptation and Disability, EA 3450 DevAH, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Faculty of Sport Sciences, UFR-STAPS, Université de Lorraine, Villers-lès-Nancy, France
| | - Jean-Marie Beis
- Development, Adaptation and Disability, EA 3450 DevAH, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Faculty of Sport Sciences, UFR-STAPS, Université de Lorraine, Villers-lès-Nancy, France
- Centre de Médecine Physique et de Réadaptation, Institut Régional de Médecine Physique et de Réadaptation de Nancy, Lay-Saint-Christophe, France
| | - Mathilde Simon
- Development, Adaptation and Disability, EA 3450 DevAH, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Faculty of Sport Sciences, UFR-STAPS, Université de Lorraine, Villers-lès-Nancy, France
| | - Ariane Rémy
- Centre de Médecine Physique et de Réadaptation, Institut Régional de Médecine Physique et de Réadaptation de Nancy, Lay-Saint-Christophe, France
| | - René Anxionnat
- Centre Hospitalier Universitaire, Service de Neuroradiologie Diagnostique et Thérapeutique, Nancy, France
| | - Jean Paysant
- Development, Adaptation and Disability, EA 3450 DevAH, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Faculty of Sport Sciences, UFR-STAPS, Université de Lorraine, Villers-lès-Nancy, France
- Centre de Médecine Physique et de Réadaptation, Institut Régional de Médecine Physique et de Réadaptation de Nancy, Lay-Saint-Christophe, France
| | - Sébastien Caudron
- Development, Adaptation and Disability, EA 3450 DevAH, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Faculty of Sport Sciences, UFR-STAPS, Université de Lorraine, Villers-lès-Nancy, France
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20
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Rorden C, Li D, Karnath HO. Biased temporal order judgments in chronic neglect influenced by trunk position. Cortex 2017; 99:273-280. [PMID: 29306707 DOI: 10.1016/j.cortex.2017.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/15/2017] [Accepted: 12/11/2017] [Indexed: 11/24/2022]
Abstract
Numerous studies have reported that temporal order perception is biased in neurological patients with extinction and neglect. These individuals tend to perceive two objectively simultaneous stimuli as occurring asynchronously, with the ipsilesional item being perceived as appearing prior to the contralesional item. Likewise, they report that two stimuli occurred simultaneously in situations where the contralesional item is presented substantially prior to the ipsilesional item. Therefore, they exhibit a biased point of subjective simultaneity (PSS). Here we demonstrate that the magnitude of this effect is modulated by the relative position of the stimuli with respect to the patient's trunk. This effect was only observed in patients who still exhibited neglect symptoms, and neither the pathological bias nor substantial modulation were observed in individuals who had recovered from neglect, those who never had neglect or neurologically healthy controls. Crucially, our design kept the retinal and head-centered coordinates of these stimuli constant, providing a pure measure for the influence of egocentric trunk position. This finding emphasizes the interaction of egocentric spatial position on the temporal symptoms observed in these individuals.
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Affiliation(s)
- Christopher Rorden
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Dongyun Li
- Center of Neurology, Division of Neuropsychology, University of Tübingen, Tübingen, Germany
| | - Hans-Otto Karnath
- Department of Psychology, University of South Carolina, Columbia, SC, USA; Center of Neurology, Division of Neuropsychology, University of Tübingen, Tübingen, Germany.
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21
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Nyffeler T, Paladini RE, Hopfner S, Job O, Nef T, Pflugshaupt T, Vanbellingen T, Bohlhalter S, Müri RM, Kerkhoff G, Cazzoli D. Contralesional Trunk Rotation Dissociates Real vs. Pseudo-Visual Field Defects due to Visual Neglect in Stroke Patients. Front Neurol 2017; 8:411. [PMID: 28861036 PMCID: PMC5562679 DOI: 10.3389/fneur.2017.00411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/31/2017] [Indexed: 11/16/2022] Open
Abstract
In stroke patients, the clinical presentation of visual field defects (VFDs) is frequently accompanied by visual neglect, i.e., the inability to attend and respond to the contralesional space. However, the diagnostic discrimination between the lack of reactions to contralesional stimuli due to VFDs or visual neglect is challenging during clinical examination. This discrimination is particularly relevant, since both clinical pictures are associated with different therapeutic approaches and outcomes. The aim of this study was to systematically investigate the effectiveness of trunk rotation toward the contralesional side-a manipulation dissociating the coordinate system of the trunk from that of the head and eyes-in disentangling real VFDs from "pseudo-VFDs" that occur due to visual neglect. Twenty patients with a left-sided VFD after a right-hemispheric stroke (10 additionally showing visual neglect in neuropsychological testing, VFD + neglect; 10 without neglect, VFD) were tested with Goldmann perimetry in both standard and trunk rotation conditions. In the standard condition, both VFD and VFD + neglect patients showed a conspicuous narrowing of the left visual field. However, trunk rotation triggered strikingly different patterns of change in the two groups: it elicited a significant increase in visual field extension in the VFD + neglect group, but left visual field extension virtually unchanged in the VFD group. Our results highlight contralesional trunk rotation as a simple, viable manipulation to effectively and rapidly disentangle real VFDs from "pseudo-VFDs" (i.e., due to visual neglect) during clinical examination.
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Affiliation(s)
- Thomas Nyffeler
- Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
- Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland
| | - Rebecca E. Paladini
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
| | - Simone Hopfner
- Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Oliver Job
- Eye Clinic, Luzerner Kantonsspital, Luzern, Switzerland
| | - Tobias Nef
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Tobias Pflugshaupt
- Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland
| | - Tim Vanbellingen
- Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
- Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland
| | - Stephan Bohlhalter
- Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
- Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland
| | - René M. Müri
- Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
- University Neurorehabilitation Clinics, Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Georg Kerkhoff
- Clinical Neuropsychology and Neuropsychological Outpatient Unit, Saarland University, Saarbrücken, Germany
| | - Dario Cazzoli
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
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22
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Li D, Rorden C, Karnath HO. "Nonspatial" Attentional Deficits Interact with Spatial Position in Neglect. J Cogn Neurosci 2017; 29:911-918. [PMID: 28129062 DOI: 10.1162/jocn_a_01101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A widely debated question concerns whether or not spatial and nonspatial components of visual attention interact in attentional performance. Spatial neglect is a common consequence of brain injury where individuals fail to respond to stimuli presented on their contralesional side. It has been argued that, beyond the spatial bias, these individuals also tend to exhibit nonspatial perceptual deficits. Here we demonstrate that the "nonspatial" deficits affecting the temporal dynamics of attentional deployment are in fact modulated by spatial position. Specifically, we observed that the pathological attentional blink of chronic neglect is enhanced when stimuli are presented on the contralesional side of the trunk while keeping retinal and head-centered coordinates constant. We did not find this pattern in right brain-damaged patients without neglect or in patients who had recovered from neglect. Our work suggests that the nonspatial attentional deficits observed in neglect are heavily modulated by egocentric spatial position. This provides strong evidence against models that suggest independent modules for spatial and nonspatial attentional functions while also providing strong evidence that trunk position plays an important role in neglect.
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23
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Rossit S, Benwell CSY, Szymanek L, Learmonth G, McKernan-Ward L, Corrigan E, Muir K, Reeves I, Duncan G, Birschel P, Roberts M, Livingstone K, Jackson H, Castle P, Harvey M. Efficacy of home-based visuomotor feedback training in stroke patients with chronic hemispatial neglect. Neuropsychol Rehabil 2017; 29:251-272. [DOI: 10.1080/09602011.2016.1273119] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | | | | | - Laura McKernan-Ward
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | - Keith Muir
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Ian Reeves
- Department of Medicine for the Elderly, Southern General Hospital, Glasgow, UK
| | - George Duncan
- Department of Medicine for the Elderly, Southern General Hospital, Glasgow, UK
| | - Philip Birschel
- Department of Medicine for the Elderly, Southern General Hospital, Glasgow, UK
| | - Margaret Roberts
- Department of Medicine for the Elderly, Southern General Hospital, Glasgow, UK
| | - Katrina Livingstone
- Stroke Discharge and Rehabilitation Team, Southern General Hospital, Glasgow, UK
| | - Hazel Jackson
- Stroke Discharge and Rehabilitation Team, Southern General Hospital, Glasgow, UK
| | | | - Monika Harvey
- School of Psychology, University of Glasgow, Glasgow, UK
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24
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Fong KNK, Chan MKL, Ng PPK, Tsang MHM, Chow KKY, Lau CWL, Chan FSM, Wong IPY, Chan DYL, Chan CC. The effect of voluntary trunk rotation and half-field eye-patching for patients with unilateral neglect in stroke: a randomized controlled trial. Clin Rehabil 2016; 21:729-41. [PMID: 17846073 DOI: 10.1177/0269215507076391] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective : To investigate the effectiveness of voluntary trunk rotation and half-field eye-patching to treat patients with unilateral neglect in stroke. Design : Pre—post, day 60 follow-up, single-blinded randomized controlled trial. Setting : Single-centre inpatient rehabilitation hospital. Subjects : Sixty subacute patients with right hemisphere stroke having unilateral neglect within eight weeks post stroke consented to participate between November 2003 and July 2005. They were randomly assigned to three comparison groups. Interventions : Nineteen patients received daily experimental training in voluntary trunk rotation (TR) for 1 hour five times a week for 30 days. Twenty patients received the same kind of treatment together with half-field eye-patching (TR + EP). Fifteen patients in the control group received conventional training with the same contact time. Main outcome measures : Patients were assessed on days 0, 30 and 60 using the Behavioural Inattention Test, the Clock Drawing Test, and the Functional Independence Measure. Results : No significant differences between voluntary trunk rotation (TR), voluntary trunk rotation and half-field eye-patching (TR + EP) and controls were found in functional performance and neglect measures at day 30 (P = 0.042—0.994) and follow-up (P = 0.052—0.911) at P = 0.005 using Bonferroni correction. Conclusions : The results of this study do not support the use of voluntary trunk rotation alone or with half-field eye-patching to improve functional performance or reduce unilateral neglect in subacute patients with stroke.
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Affiliation(s)
- Kenneth N K Fong
- Department of Rehabilitation Sciences, the Hong Kong Polytechnic University, Kowloon.
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Gallace A, Auvray M, Spence C. The Modulation of Haptic Line Bisection by a Visual Illusion and Optokinetic Stimulation. Perception 2016; 36:1003-18. [PMID: 17844966 DOI: 10.1068/p5457] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Research has shown that a variety of different sensory manipulations, including visual illusions, transcutaneous nerve stimulation, vestibular caloric stimulation, optokinetic stimulation, and prism adaptation, can all influence people's performance on spatial tasks such as line bisection. It has been suggested that these manipulations may act upon the ‘higher-order’ levels of representation used to code spatial information. We investigated whether we could influence haptic line bisection in normal participants crossmodally by varying the visual background that participants viewed. In experiment 1, participants haptically bisected wooden rods while looking at a variant of the Oppel–Kundt visual illusion. Haptic-bisection judgments were influenced by the orientation of the visual illusion (in line with previous unimodal visual findings). In experiment 2, haptic-bisection judgments were also influenced by the presence of a leftward or rightward moving visual background. In experiments 3 and 4, the position of the to-be-bisected stimuli was varied with respect to the participant's body midline. The results confirmed an effect of optokinetic stimulation, but not of the Oppel–Kundt illusion, on participants' tactile-bisection errors, suggesting that the two manipulations might differentially affect haptic processing. Taken together, these results suggest that the ‘higher-order’ levels of spatial representation upon which perceptual judgments and/or motor responses are made may have multisensory or amodal characteristics.
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Affiliation(s)
- Alberto Gallace
- Department of Experimental Psychology, University of Oxford, South Parks Road, Oxford OX1 3UD, UK.
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Leplaideur S, Leblong E, Jamal K, Rousseau C, Raillon AM, Coignard P, Damphousse M, Bonan I. Short-term effect of neck muscle vibration on postural disturbances in stroke patients. Exp Brain Res 2016; 234:2643-51. [PMID: 27165509 DOI: 10.1007/s00221-016-4668-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 04/28/2016] [Indexed: 01/01/2023]
Abstract
Balance disorders after stroke have a particularly detrimental influence on recovery of autonomy and walking. The present study is aimed at assessing the effect of proprioceptive stimulation by neck muscle vibration (NMV) on the balance of patients with right hemispheric lesion (RHL) and left hemispheric lesion (LHL). Thirty-one (31) patients (15 RHL and 16 LHL), mean age 61.5 years (±10.6), mean delay 3.1 (±1.6) months after one hemispheric stroke were included in this prospective study. The mean position in mediolateral and anteroposterior plane of the CoP (center of pressure) and the surface were evaluated using a force platform at rest and immediately after 10 min of vibration on the contralesional dorsal neck muscle. NMV decreases the lateral deviation balance induced by the stroke. Twenty patients (64.5 %) experienced a visual illusion of light spot moving toward the side opposite stimulus. These patients showed more improvement by vibration than those without visual illusion. There was an interaction between sensitivity and side of stroke on the effect of NMV. Proprioceptive stimulation by NMV reduces postural asymmetry after stroke. This short-term effect of the vibration is more effective in patients susceptible to visual illusion. This result was consistent with a central effect of NMV on the structures involved in the elaboration of perception of body in space.
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Affiliation(s)
- Stéphanie Leplaideur
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, 2 Rue Henri Le Guilloux, 35033, Rennes, France.
- Neurology Physical and Rehabilitation Medicine Department, KERPAPE, BP 78, 56275, Ploemeur Cedex, France.
| | - Emilie Leblong
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, 2 Rue Henri Le Guilloux, 35033, Rennes, France
| | - Karim Jamal
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, 2 Rue Henri Le Guilloux, 35033, Rennes, France
| | - Chloé Rousseau
- Department of Clinical Pharmacology, Clinical Investigation Center INSERM 1414, University Hospital of Rennes, 2 Rue Henri Le Guilloux, 35033, Rennes, France
| | - Annelise Moulinet Raillon
- Physical and Rehabilitation Medicine Department, Hospital of Boulogne sur Mer, 33 Rue Jacques Monod, 62200, Boulogne sur Mer, France
| | - Pauline Coignard
- Neurology Physical and Rehabilitation Medicine Department, KERPAPE, BP 78, 56275, Ploemeur Cedex, France
| | - Mireille Damphousse
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, 2 Rue Henri Le Guilloux, 35033, Rennes, France
| | - Isabelle Bonan
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, 2 Rue Henri Le Guilloux, 35033, Rennes, France
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Calzolari E, Gallace A, Moseley GL, Vallar G. Effect of prism adaptation on thermoregulatory control in humans. Behav Brain Res 2016; 296:339-350. [DOI: 10.1016/j.bbr.2015.08.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 08/25/2015] [Accepted: 08/27/2015] [Indexed: 11/24/2022]
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Abstract
This paper describes a new observation of neglect and extinction of kinesthesia and thesesthesia (movement and position imperception), jointly reflecting proprioceptive inattention, in a series of patients with parietal lesions. A prototypical case is discussed in detail and unaddressed aspects of proprioceptive inattention are discussed through findings from four additional cases. Thesesthetic and kinesthetic extinction were tested through simultaneous antidromic vertical displacement of index fingers, while having patients report on finger proprioceptive perception with eyes closed. Patients had variable degrees of proprioceptive inattention affecting a specific limb, but without pallesthetic inattention or somatoagnosia, whereas symptoms often resolved with visual feedback or active limb movements. Findings support that kinesthesia and thesesthesia (a) are subserved by near-identical brain networks, (b) relate more to tactile perception than pallesthesia in higher order cortical areas, and (c) have a somatotopic cortical organization even in association brain areas. Furthermore, proprioceptive extinction and neglect involve (i) "attention network" structures, (ii) either hemisphere, (iii) gray or subcortical white matter damage, (iv) defective vigilance mechanisms possibly through premature habituation of spatiotemporally saturated neural capacitor circuits, and (v) are not the result of somatoagnosia, while (vi) their resolution is observed through reafferent motor-sensory or visual feedback.
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Affiliation(s)
- Elissaios Karageorgiou
- a Memory and Aging Center, Department of Neurology , University of California San Francisco , San Francisco , CA , 94158 , USA.,b Department of Neurology , University of Minnesota , Minneapolis , MN , 55455 , USA.,c Neurological Institute of Athens , Athens , 10676 , Greece
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Oh SI, Kim JK, Park SY. The effects of prism glasses and intensive upper limb exercise on hemineglect, upper limb function, and activities of daily living in stroke patients: a case series. J Phys Ther Sci 2015; 27:3941-3. [PMID: 26834386 PMCID: PMC4713825 DOI: 10.1589/jpts.27.3941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 09/24/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to examine the effects of visual field with prism glasses, and
intensive upper limb functional training on reduction of hemineglect and improvement in
upper limb function and activities of daily living in three stroke patients with
hemineglect. [Subjects] This study included three stroke patients hospitalized in a
sanatorium. [Methods] Intervention treatment involving prism glass use for 12 hours and 30
minutes and paretic side upper limb training was conducted 5 days a week for 15 weeks.
Three upper limb training tasks (hitting a balloon, passing through a ring, and reading a
newspaper) were performed for 10 minutes each session, for a total of 30 minutes. Line by
Section, Motor-Free Visual Perception Test-3 (MVPT-3), Manual Function Test (MFT), Box
& Block Test (BBT), and Assessment of Motor and Process Skills (AMPS) were conducted
before and after intervention. [Results] Subjects’ hemineglect decreased and upper limb
function on the paretic side improved after intervention, which enhanced activities of
daily living. [Conclusion] Prism glass use and paretic upper limb functional training
effectively ameliorated stroke patients’ hemineglect and improved upper limb function.
Future research should focus on prism glasses that provide a wide visual field for use in
patients with different conditions.
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Affiliation(s)
- Se-Il Oh
- Department of Occupational Therapy, Rehabilitation Clinic, Joy Hospital, Republic of Korea
| | - Jin-Kyung Kim
- Department of Occupational Therapy, College of Health Science, Hanseo University, Republic of Korea
| | - So-Yeon Park
- Department of Occupational Therapy, College of Health Science, Hanseo University, Republic of Korea
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Effect of sensorial stimulations on postural disturbances related to spatial cognition disorders after stroke. Neurophysiol Clin 2015; 45:297-303. [PMID: 26527133 DOI: 10.1016/j.neucli.2015.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 09/22/2015] [Indexed: 11/21/2022] Open
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Paschke K, Kagan I, Wüstenberg T, Bähr M, Wilke M. Trunk rotation affects temporal order judgments with direct saccades: Influence of handedness. Neuropsychologia 2015; 79:123-37. [PMID: 26518506 DOI: 10.1016/j.neuropsychologia.2015.10.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/21/2015] [Accepted: 10/25/2015] [Indexed: 10/22/2022]
Abstract
Manipulation of the trunk midline has been shown to improve visuospatial performance in patients with unilateral visual neglect. The goal of the present study was to disentangle motor and perceptual components of egocentric midline manipulations and to investigate the contribution of individual hand preference. Two versions of visual temporal order judgment (TOJ) tasks were tested in healthy right- and left-handed subjects while trunk rotation was varied. In the congruent version, subjects were required to execute a saccade to the first of two horizontal stimuli presented with different stimulus onset asynchronies (SOA). In the incongruent version, subjects were required to perform a vertical saccade to a pre-learned color target, thereby dissociating motor response from the perceptual stimulus location. The main findings of this study are a trunk rotation and response direction specific impact on temporal judgments in form of a prior entry bias for right hemifield stimuli during rightward trunk rotation, but only in the congruent task. This trunk rotation-induced spatial bias was most pronounced in left-handed participants but had the same sign in the right-handed group. Results suggest that egocentric midline shifts in healthy subjects induce a spatially-specific motor, but not a perceptual, bias and underline the importance of taking individual differences in functional laterality such as handedness and mode of perceptual report into account when evaluating effects of trunk rotation in either healthy subjects or neurological patients.
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Affiliation(s)
- Kerstin Paschke
- Department of Cognitive Neurology, University Medicine Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany; Department of Neurology, University Medicine Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany; Department of Child and Adolescent Psychiatry, University Medicine Goettingen, von-Siebold-Str. 5, 37075 Goettingen, Germany
| | - Igor Kagan
- Department of Cognitive Neurology, University Medicine Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany; German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, 37077 Goettingen, Germany
| | - Torsten Wüstenberg
- Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany
| | - Mathias Bähr
- Department of Neurology, University Medicine Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany; DFG Center for Nanoscale Microscopy & Molecular Physiology of the Brain (CNMPB), Germany
| | - Melanie Wilke
- Department of Cognitive Neurology, University Medicine Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany; German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, 37077 Goettingen, Germany; DFG Center for Nanoscale Microscopy & Molecular Physiology of the Brain (CNMPB), Germany.
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32
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Spatial attention systems in spatial neglect. Neuropsychologia 2015; 75:61-73. [DOI: 10.1016/j.neuropsychologia.2015.05.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 05/15/2015] [Accepted: 05/20/2015] [Indexed: 11/23/2022]
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Pettorossi VE, Schieppati M. Neck proprioception shapes body orientation and perception of motion. Front Hum Neurosci 2014; 8:895. [PMID: 25414660 PMCID: PMC4220123 DOI: 10.3389/fnhum.2014.00895] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 10/20/2014] [Indexed: 12/30/2022] Open
Abstract
This review article deals with some effects of neck muscle proprioception on human balance, gait trajectory, subjective straight-ahead (SSA), and self-motion perception. These effects are easily observed during neck muscle vibration, a strong stimulus for the spindle primary afferent fibers. We first remind the early findings on human balance, gait trajectory, SSA, induced by limb, and neck muscle vibration. Then, more recent findings on self-motion perception of vestibular origin are described. The use of a vestibular asymmetric yaw-rotation stimulus for emphasizing the proprioceptive modulation of motion perception from the neck is mentioned. In addition, an attempt has been made to conjointly discuss the effects of unilateral neck proprioception on motion perception, SSA, and walking trajectory. Neck vibration also induces persistent aftereffects on the SSA and on self-motion perception of vestibular origin. These perceptive effects depend on intensity, duration, side of the conditioning vibratory stimulation, and on muscle status. These effects can be maintained for hours when prolonged high-frequency vibration is superimposed on muscle contraction. Overall, this brief outline emphasizes the contribution of neck muscle inflow to the construction and fine-tuning of perception of body orientation and motion. Furthermore, it indicates that tonic neck-proprioceptive input may induce persistent influences on the subject's mental representation of space. These plastic changes might adapt motion sensitiveness to lasting or permanent head positional or motor changes.
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Affiliation(s)
| | - Marco Schieppati
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Centro Studi Attività Motorie (CSAM), Fondazione Salvatore Maugeri (IRCSS), Scientific Institute of Pavia, Pavia, Italy
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34
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Pitteri M, Kerkhoff G, Keller I, Meneghello F, Priftis K. Extra-powerful on the visuo-perceptual space, but variable on the number space: Different effects of optokinetic stimulation in neglect patients. J Neuropsychol 2014; 9:299-318. [PMID: 25145402 DOI: 10.1111/jnp.12051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 07/10/2014] [Indexed: 11/26/2022]
Abstract
We studied the effects of optokinetic stimulation (OKS; leftward, rightward, control) on the visuo-perceptual and number space, in the same sample, during line bisection and mental number interval bisection tasks. To this end, we tested six patients with right-hemisphere damage and neglect, six patients with right-hemisphere damage but without neglect, and six neurologically healthy participants. In patients with neglect, we found a strong effect of leftward OKS on line bisection, but not on mental number interval bisection. We suggest that OKS influences the number space only under specific conditions.
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Affiliation(s)
- Marco Pitteri
- Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy
| | - Georg Kerkhoff
- Clinical Neuropsychology Unit and Outpatient Service, Saarland University, Saarbrücken, Germany.,International Research Training Group 1457 "Adaptive Minds", Saarbrücken, Germany
| | - Ingo Keller
- Clinical Neuropsychology Unit, Schön Clinic Bad Aibling, Germany
| | | | - Konstantinos Priftis
- Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy.,Department of General Psychology, University of Padova, Italy
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35
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Pezzulo G, Iodice P, Ferraina S, Kessler K. Shared action spaces: a basis function framework for social re-calibration of sensorimotor representations supporting joint action. Front Hum Neurosci 2013; 7:800. [PMID: 24324425 PMCID: PMC3840313 DOI: 10.3389/fnhum.2013.00800] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 11/03/2013] [Indexed: 11/17/2022] Open
Abstract
The article explores the possibilities of formalizing and explaining the mechanisms that support spatial and social perspective alignment sustained over the duration of a social interaction. The basic proposed principle is that in social contexts the mechanisms for sensorimotor transformations and multisensory integration (learn to) incorporate information relative to the other actor(s), similar to the “re-calibration” of visual receptive fields in response to repeated tool use. This process aligns or merges the co-actors’ spatial representations and creates a “Shared Action Space” (SAS) supporting key computations of social interactions and joint actions; for example, the remapping between the coordinate systems and frames of reference of the co-actors, including perspective taking, the sensorimotor transformations required for lifting jointly an object, and the predictions of the sensory effects of such joint action. The social re-calibration is proposed to be based on common basis function maps (BFMs) and could constitute an optimal solution to sensorimotor transformation and multisensory integration in joint action or more in general social interaction contexts. However, certain situations such as discrepant postural and viewpoint alignment and associated differences in perspectives between the co-actors could constrain the process quite differently. We discuss how alignment is achieved in the first place, and how it is maintained over time, providing a taxonomy of various forms and mechanisms of space alignment and overlap based, for instance, on automaticity vs. control of the transformations between the two agents. Finally, we discuss the link between low-level mechanisms for the sharing of space and high-level mechanisms for the sharing of cognitive representations.
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Affiliation(s)
- Giovanni Pezzulo
- Institute of Cognitive Sciences and Technologies, National Research Council Rome, Italy
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36
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Chen X, Deangelis GC, Angelaki DE. Diverse spatial reference frames of vestibular signals in parietal cortex. Neuron 2013; 80:1310-21. [PMID: 24239126 DOI: 10.1016/j.neuron.2013.09.006] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2013] [Indexed: 10/26/2022]
Abstract
Reference frames are important for understanding how sensory cues from different modalities are coordinated to guide behavior, and the parietal cortex is critical to these functions. We compare reference frames of vestibular self-motion signals in the ventral intraparietal area (VIP), parietoinsular vestibular cortex (PIVC), and dorsal medial superior temporal area (MSTd). Vestibular heading tuning in VIP is invariant to changes in both eye and head positions, indicating a body (or world)-centered reference frame. Vestibular signals in PIVC have reference frames that are intermediate between head and body centered. In contrast, MSTd neurons show reference frames between head and eye centered but not body centered. Eye and head position gain fields were strongest in MSTd and weakest in PIVC. Our findings reveal distinct spatial reference frames for representing vestibular signals and pose new challenges for understanding the respective roles of these areas in potentially diverse vestibular functions.
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Affiliation(s)
- Xiaodong Chen
- Department of Neuroscience, Baylor College of Medicine, Houston, TX 77030, USA
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37
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Chen J, Niemeier M. Do head-on-trunk signals modulate disengagement of spatial attention? Exp Brain Res 2013; 232:147-57. [DOI: 10.1007/s00221-013-3727-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 09/27/2013] [Indexed: 10/26/2022]
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38
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Guinet M, Michel C. Prism adaptation and neck muscle vibration in healthy individuals: are two methods better than one? Neuroscience 2013; 254:443-51. [PMID: 24035829 DOI: 10.1016/j.neuroscience.2013.08.067] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Revised: 08/29/2013] [Accepted: 08/29/2013] [Indexed: 11/18/2022]
Abstract
Studies involving therapeutic combinations reveal an important benefit in the rehabilitation of neglect patients when compared to single therapies. In light of these observations our present work examines, in healthy individuals, sensorimotor and cognitive after-effects of prism adaptation and neck muscle vibration applied individually or simultaneously. We explored sensorimotor after-effects on visuo-manual open-loop pointing, visual and proprioceptive straight-ahead estimations. We assessed cognitive after-effects on the line bisection task. Fifty-four healthy participants were divided into six groups designated according to the exposure procedure used with each: 'Prism' (P) group; 'Vibration with a sensation of body rotation' (Vb) group; 'Vibration with a move illusion of the LED' (Vl) group; 'Association with a sensation of body rotation' (Ab) group; 'Association with a move illusion of the LED' (Al) group; and 'Control' (C) group. The main findings showed that prism adaptation applied alone or combined with vibration showed significant adaptation in visuo-manual open-loop pointing, visual straight-ahead and proprioceptive straight-ahead. Vibration alone produced significant after-effects on proprioceptive straight-ahead estimation in the Vl group. Furthermore all groups (except C group) showed a rightward neglect-like bias in line bisection following the training procedure. This is the first demonstration of cognitive after-effects following neck muscle vibration in healthy individuals. The simultaneous application of both methods did not produce significant greater after-effects than prism adaptation alone in both sensorimotor and cognitive tasks. These results are discussed in terms of transfer of sensorimotor plasticity to spatial cognition in healthy individuals.
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Affiliation(s)
- M Guinet
- Université de Bourgogne, Campus Universitaire, UFR STAPS, BP 27877, Dijon F-21078, France; INSERM, U 1093, Cognition, Action et Plasticité sensorimotrice, Dijon F-21078, France
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39
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Bailey MJ, Riddoch MJ. Hemineglect in stroke patients. Part 2. Rehabilitation techniques and strategies: a summary of recent studies. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/ptr.1999.4.2.77] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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40
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Pitteri M, Arcara G, Passarini L, Meneghello F, Priftis K. Is two better than one? Limb activation treatment combined with contralesional arm vibration to ameliorate signs of left neglect. Front Hum Neurosci 2013; 7:460. [PMID: 23966926 PMCID: PMC3735991 DOI: 10.3389/fnhum.2013.00460] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 07/24/2013] [Indexed: 11/13/2022] Open
Abstract
In the present study, we evaluated the effects of the Limb Activation Treatment (LAT) alone and in combination with the Contralateral Arm Vibration (CAV) on left neglect (LN) rehabilitation. We conceived them as techniques that both prompt the activation of the lesioned right hemisphere because of the activation (with the LAT as an active technique) and the stimulation (with the CAV as a passive technique) of the left hemibody. To test the effect of the simultaneous use of these two techniques (i.e., LAT and CAV) on visuo-spatial aspects of LN, we described the case of an LN patient (GR), who showed high intra-individual variability (IIV) in performance. Given the high IIV of GR, we used an ABAB repeated-measures design to better define the effectiveness of the combined application of LAT and CAV, as a function of time. The results showed an improvement of GR's performance on the Bells test following the combined application of LAT and CAV, with respect to the application of LAT alone. We did not find, however, significant effects of treatment on two other LN tests (i.e., Line bisection and Picture scanning). We propose that the combined application of LAT and CAV can be beneficial for some aspects of LN.
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Affiliation(s)
- Marco Pitteri
- Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy
| | - Giorgio Arcara
- Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy
| | - Laura Passarini
- Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy
| | | | - Konstantinos Priftis
- Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy
- Department of General Psychology, University of Padova, Padova, Italy
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41
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Nakatani K, Notoya M, Sunahara N, Takahashi S, Inoue K. Horizontal visual search in a large field by patients with unilateral spatial neglect. J Clin Neurosci 2013; 20:837-41. [PMID: 23632293 DOI: 10.1016/j.jocn.2012.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 07/04/2012] [Accepted: 07/06/2012] [Indexed: 10/26/2022]
Abstract
In this study, we investigated the horizontal visual search ability and pattern of horizontal visual search in a large space performed by patients with unilateral spatial neglect (USN). Subjects included nine patients with right hemisphere damage caused by cerebrovascular disease showing left USN, nine patients with right hemisphere damage but no USN, and six healthy individuals with no history of brain damage who were age-matched to the groups with brain right hemisphere damage. The number of visual search tasks accomplished was recorded in the first experiment. Neck rotation angle was continuously measured during the task and quantitative data of the measurements were collected. There was a strong correlation between the number of visual search tasks accomplished and the total Behavioral Inattention Test Conventional Subtest (BITC) score in subjects with right hemisphere damage. In both USN and control groups, the head position during the visual search task showed a balanced bell-shaped distribution from the central point on the field to the left and right sides. Our results indicate that compensatory strategies, including cervical rotation, may improve visual search capability and achieve balance on the neglected side.
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Affiliation(s)
- Ken Nakatani
- Section of Communication Disorders, Faculty of Health Care Sciences, Himeji Dokkyo University, 7-2-1 Kami-ono, Himeji, Hyogo 670-8524, Japan.
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Saevarsson S. Motor Response Deficits of Unilateral Neglect: Assessment, Therapy, and Neuroanatomy. APPLIED NEUROPSYCHOLOGY-ADULT 2013; 20:292-305. [DOI: 10.1080/09084282.2012.710682] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Styrmir Saevarsson
- a Clinical Neuropsychology Research Group (EKN), Bogenhausen University Hospital , Munich , Germany
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43
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Maxton C, Dineen RA, Padamsey RC, Munshi SK. Don't neglect 'neglect'- an update on post stroke neglect. Int J Clin Pract 2013; 67:369-78. [PMID: 23521329 DOI: 10.1111/ijcp.12058] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Post-stroke neglect is common and an independent predictor of functional outcome. Assessment of neglect is very demanding, the treatment extremely difficult and the literature vast; we performed a literature search for all aspects of this difficult subject. METHODS We searched the PubMed, EMBASE databases and historical manuals for authoritative studies on post stroke neglect between 1951 and 2011. FINDINGS There is a great dearth of randomised controlled data on neglect because standardised assessment does not occur frequently. Eighty-eight manuscripts were identified in the literature, which were quite heterogeneous in their content and addressing diverse aspects of this clinical entity. INTERPRETATION AND IMPLICATIONS The most important historical papers were selected along with the most widely accepted and proven strategies for assessment and treatment. Standardised assessment of neglect does not always occur, but several useful strategies are available and are described in the following sections.
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Affiliation(s)
- C Maxton
- Department of Stroke Medicine, Nottingham University Hospital, Nottingham, UK
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Orand A, Okamoto S, Tomita Y, Miyasaka H, Tanino G, Sonoda S. Multi-input/output alarming system for patients with inattention caused by higher cortical function disorder. Biomed Eng Online 2013; 12:104. [PMID: 24119204 PMCID: PMC3852334 DOI: 10.1186/1475-925x-12-104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 09/20/2013] [Indexed: 11/10/2022] Open
Abstract
Background Method Results Conclusion
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Cazzoli D, Muri RM, Schumacher R, von Arx S, Chaves S, Gutbrod K, Bohlhalter S, Bauer D, Vanbellingen T, Bertschi M, Kipfer S, Rosenthal CR, Kennard C, Bassetti CL, Nyffeler T. Theta burst stimulation reduces disability during the activities of daily living in spatial neglect. Brain 2012; 135:3426-39. [DOI: 10.1093/brain/aws182] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Maravita A, Cigada M, Posteraro L. Talking to the senses: modulation of tactile extinction through hypnotic suggestion. Front Hum Neurosci 2012; 6:210. [PMID: 22822395 PMCID: PMC3398471 DOI: 10.3389/fnhum.2012.00210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 06/27/2012] [Indexed: 11/13/2022] Open
Abstract
Following brain damage, typically of the right hemisphere, patients can show reduced awareness of sensory events occurring in the space contralateral to the brain damage. The present work shows that a hypnotic suggestion can temporarily reduce tactile extinction to double bilateral stimulation, i.e., a loss of contralesional stimuli when these are presented together with ipsilesional ones. Patient EB showed an improved detection of contralesional targets after a single 20-min hypnosis session, during which specific suggestions were delivered with the aim of increasing her insight into somatosensory perception on both sides of the body. Simple overt attention orienting toward the contralesional side, or a hypnotic induction procedure not accompanied by specifically aimed suggestions, were not effective in modulating extinction. The present result is the first systematic evidence that hypnosis can temporarily improve a neuropsychological condition, namely Extinction, and may open the way for the use of this technique as a fruitful rehabilitative tool for brain-damaged patients affected by neuropsychological deficits.
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Affiliation(s)
- Angelo Maravita
- Department of Psychology, University of Milano-Bicocca Milano, Italy
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Heidler-Gary J, Pawlak M, Herskovits EH, Newhart M, Davis C, Trupe LA, Hillis AE. Motor extinction in distinct reference frames: a double dissociation. Behav Neurol 2012; 26:111-9. [PMID: 22713397 PMCID: PMC3459173 DOI: 10.3233/ben-2012-110254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Test the hypothesis that right hemisphere stroke can cause extinction of left hand movements or movements of either hand held in left space, when both are used simultaneously, possibly depending on lesion site. METHODS 93 non-hemiplegic patients with acute right hemisphere stroke were tested for motor extinction by pressing a counter rapidly for one minute with the right hand, left hand, or both simultaneously with their hands held at their sides, or crossed over midline. RESULTS We identified two distinct types of motor extinction in separate patients; 20 patients extinguished left hand movements held in left or right space (left canonical body extinction); the most significantly associated voxel cluster of ischemic tissue was in the right temporal white matter. Seven patients extinguished either hand held in left space (left space extinction), and the most significantly associated voxel cluster of ischemic tissue was in right parietal white matter. CONCLUSIONS There was a double dissociation between left canonical body extinction and left space motor extinction. Left canonical body extinction seems to be associated with more dorsal (parietal) ischemia, and left canonical body extinction seems to be associated with more ventral (temporal) ischemia.
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Affiliation(s)
- Jennifer Heidler-Gary
- Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
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Kerkhoff G, Schenk T. Rehabilitation of neglect: an update. Neuropsychologia 2012; 50:1072-9. [PMID: 22306520 DOI: 10.1016/j.neuropsychologia.2012.01.024] [Citation(s) in RCA: 152] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 01/11/2012] [Accepted: 01/12/2012] [Indexed: 11/17/2022]
Abstract
Spatial neglect is a characteristic sign of damage to the right hemisphere and is typically characterized by a failure to respond to stimuli on the left side. With about a third of stroke victims showing initial signs of neglect, it is a frequent but also one of the most disabling neurological syndromes. Despite partial recovery in the first months after stroke one third of these patients remain severely disabled in all daily activities, have a poor rehabilitation outcome and therefore require specific treatment. The last decades have seen an intensive search for novel, more effective treatments for this debilitating disorder. An impressive range of techniques to treat neglect has been developed in recent years. Here, we describe those techniques, review their efficacy and identify gaps in the current research on neglect therapy.
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Affiliation(s)
- Georg Kerkhoff
- Saarland University, Clinical Neuropsychology Unit and University Ambulance, Saarbruecken, Germany.
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Vandenberghe R, Molenberghs P, Gillebert CR. Spatial attention deficits in humans: the critical role of superior compared to inferior parietal lesions. Neuropsychologia 2012; 50:1092-103. [PMID: 22266260 DOI: 10.1016/j.neuropsychologia.2011.12.016] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 11/28/2011] [Accepted: 12/23/2011] [Indexed: 11/24/2022]
Abstract
According to a longstanding view, inferior as opposed to superior parietal cortex critically contributes to the spatial attentional deficits encountered following unilateral parietal ischemic lesions. We review the evidence on which this view is based and contrast it with more recent structural lesion evidence concerning the critical role of the intraparietal sulcus in spatial attention deficits. In a classical spatial cueing paradigm, focal lesions of the posterior and of the middle segment of the intraparietal sulcus give rise to a pathological invalidity effect that is indistinguishable from that seen after classical inferior parietal lesions. When a competing distracter is added to a target stimulus, the deleterious consequences of focal IPS lesions are again very similar to those classically observed following inferior parietal lesions. The deficit could not be accounted for by functional effects at a distance affecting inferior parietal cortex. These single-case lesion data establish the critical role of the posterior and the middle IPS segment in spatially selective attention and are in line with a vast amount of functional imaging evidence in the intact brain pointing to the prominent role of the intraparietal sulcus in spatial attention, along with inferior parietal cortex under specific circumstances. Functional imaging has also provided hints about the differences in functional contribution between inferior and superior parietal cortex. These hypotheses await further confirmation based on lesion evidence.
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Affiliation(s)
- Rik Vandenberghe
- Laboratory for Cognitive Neurology, Neurology Department, University Hospitals Leuven, Leuven, Belgium.
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Fukushima K, Fukushima J, Warabi T. Vestibular-related frontal cortical areas and their roles in smooth-pursuit eye movements: representation of neck velocity, neck-vestibular interactions, and memory-based smooth-pursuit. Front Neurol 2011; 2:78. [PMID: 22174706 PMCID: PMC3237097 DOI: 10.3389/fneur.2011.00078] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 11/20/2011] [Indexed: 11/13/2022] Open
Abstract
Smooth-pursuit eye movements are voluntary responses to small slow-moving objects in the fronto-parallel plane. They evolved in primates, who possess high-acuity foveae, to ensure clear vision about the moving target. The primate frontal cortex contains two smooth-pursuit related areas; the caudal part of the frontal eye fields (FEF) and the supplementary eye fields (SEF). Both areas receive vestibular inputs. We review functional differences between the two areas in smooth-pursuit. Most FEF pursuit neurons signal pursuit parameters such as eye velocity and gaze-velocity, and are involved in canceling the vestibulo-ocular reflex by linear addition of vestibular and smooth-pursuit responses. In contrast, gaze-velocity signals are rarely represented in the SEF. Most FEF pursuit neurons receive neck velocity inputs, while discharge modulation during pursuit and trunk-on-head rotation adds linearly. Linear addition also occurs between neck velocity responses and vestibular responses during head-on-trunk rotation in a task-dependent manner. During cross-axis pursuit-vestibular interactions, vestibular signals effectively initiate predictive pursuit eye movements. Most FEF pursuit neurons discharge during the interaction training after the onset of pursuit eye velocity, making their involvement unlikely in the initial stages of generating predictive pursuit. Comparison of representative signals in the two areas and the results of chemical inactivation during a memory-based smooth-pursuit task indicate they have different roles; the SEF plans smooth-pursuit including working memory of motion-direction, whereas the caudal FEF generates motor commands for pursuit eye movements. Patients with idiopathic Parkinson's disease were asked to perform this task, since impaired smooth-pursuit and visual working memory deficit during cognitive tasks have been reported in most patients. Preliminary results suggested specific roles of the basal ganglia in memory-based smooth-pursuit.
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