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Overman MJ, Binns E, Milosevich ET, Demeyere N. Recovery of Visuospatial Neglect With Standard Treatment: A Systematic Review and Meta-Analysis. Stroke 2024; 55:2325-2339. [PMID: 39016005 PMCID: PMC11346719 DOI: 10.1161/strokeaha.124.046760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 06/05/2024] [Accepted: 06/21/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Visuospatial neglect is a common consequence of stroke and is characterized by impaired attention to contralesional space. Currently, the extent and time course of recovery from neglect are not clearly established. This systematic review and meta-analysis aimed to determine the recovery trajectory of poststroke neglect with standard treatment. METHODS PsycInfo, Embase, and MEDLINE were searched for articles reporting recovery rates of neglect after stroke. Time since stroke was categorized into early (0-3 months), mid (3-6 months), and late (>6 months) recovery phases. Random-effects models for pooled prevalence were generated for each phase, and potential sources of heterogeneity were explored with metaregressions. Methodological quality of each study was assessed using the Joanna Briggs Institute checklist, with low-quality studies excluded in sensitivity analyses. RESULTS The search captured 4130 articles including duplicates, and 111 full-text reviews were undertaken. A total of 27 studies reporting data from 839 stroke survivors with neglect were included for review. Meta-analyses indicated a recovery rate of 42% in the early phase, which increased to 53% in the mid-recovery phase. Additional recovery in the late phase was minimal, with an estimated 56% recovery rate. Heterogeneity of studies was high (I2>75%) in all 3 phases of recovery. Estimates were robust to sensitivity analyses. Metaregressions showed significantly greater recovery in studies that included patients with left-hemisphere lesions (β=0.275, P<0.05, I2=84%). CONCLUSIONS Most recovery from neglect occurs in the first 3 months, although additional gains can be expected up to 6 months poststroke. While a large proportion of patients recover from neglect, over 40% show persistent symptoms. Further research is needed on effective rehabilitation interventions, particularly focusing on patients most at risk of chronic visuospatial neglect. REGISTRATION URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42023388763.
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Affiliation(s)
- Margot Juliëtte Overman
- Department of Experimental Psychology (M.J.O., E.B., E.T.M.), University of Oxford, United Kingdom
| | - Elena Binns
- Department of Experimental Psychology (M.J.O., E.B., E.T.M.), University of Oxford, United Kingdom
| | - Elise T. Milosevich
- Department of Experimental Psychology (M.J.O., E.B., E.T.M.), University of Oxford, United Kingdom
| | - Nele Demeyere
- Nuffield Department of Clinical Neurosciences (N.D.), University of Oxford, United Kingdom
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2
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Carson RG, Hayward KS. Using mechanistic knowledge to appraise contemporary approaches to the rehabilitation of upper limb function following stroke. J Physiol 2024. [PMID: 39129269 DOI: 10.1113/jp285559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 07/12/2024] [Indexed: 08/13/2024] Open
Abstract
It is a paradox of neurological rehabilitation that, in an era in which preclinical models have produced significant advances in our mechanistic understanding of neural plasticity, there is inadequate support for many therapies recommended for use in clinical practice. When the goal is to estimate the probability that a specific form of therapy will have a positive clinical effect, the integration of mechanistic knowledge (concerning 'the structure or way of working of the parts in a natural system') may improve the quality of inference. This is illustrated by analysis of three contemporary approaches to the rehabilitation of lateralized dysfunction affecting people living with stroke: constraint-induced movement therapy; mental practice; and mirror therapy. Damage to 'cross-road' regions of the structural (white matter) brain connectome generates deficits that span multiple domains (motor, language, attention and verbal/spatial memory). The structural integrity of these regions determines not only the initial functional status, but also the response to therapy. As structural disconnection constrains the recovery of functional capability, 'disconnectome' modelling provides a basis for personalized prognosis and precision rehabilitation. It is now feasible to refer a lesion delineated using a standard clinical scan to a (dis)connectivity atlas derived from the brains of other stroke survivors. As the individual disconnection pattern thus obtained suggests the functional domains most likely be compromised, a therapeutic regimen can be tailored accordingly. Stroke is a complex disorder that burdens individuals with distinct constellations of brain damage. Mechanistic knowledge is indispensable when seeking to ameliorate the behavioural impairments to which such damage gives rise.
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Affiliation(s)
- Richard G Carson
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin 2, Ireland
- School of Psychology, Queen's University Belfast, Belfast, UK
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Kathryn S Hayward
- Departments of Physiotherapy, University of Melbourne, Melbourne, Australia
- Department of Medicine, University of Melbourne, Melbourne, Australia
- The Florey, University of Melbourne, Melbourne, Australia
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3
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Martín-Signes M, Chica AB, Bartolomeo P, Thiebaut de Schotten M. Streams of conscious visual experience. Commun Biol 2024; 7:908. [PMID: 39068236 PMCID: PMC11283449 DOI: 10.1038/s42003-024-06593-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 07/17/2024] [Indexed: 07/30/2024] Open
Abstract
Consciousness, a cornerstone of human cognition, is believed to arise from complex neural interactions. Traditional views have focused on localized fronto-parietal networks or broader inter-regional dynamics. In our study, we leverage advanced fMRI techniques, including the novel Functionnectome framework, to unravel the intricate relationship between brain circuits and functional activity shaping visual consciousness. Our findings underscore the importance of the superior longitudinal fasciculus within the fronto-parietal fibers, linking conscious perception with spatial neglect. Additionally, our data reveal the critical contribution of the temporo-parietal fibers and the splenium of the corpus callosum in connecting visual information with conscious representation and their verbalization. Central to these networks is the thalamus, posited as a conductor in synchronizing these interactive processes. Contrasting traditional fMRI analyses with the Functionnectome approach, our results emphasize the important explanatory power of interactive mechanisms over localized activations for visual consciousness. This research paves the way for a comprehensive understanding of consciousness, highlighting the complex network of neural connections that lead to awareness.
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Affiliation(s)
- Mar Martín-Signes
- Experimental Psychology Department, and Brain, Mind, and Behavior Research Center (CIMCYC-UGR), University of Granada, Granada, Spain.
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, Bordeaux, France.
| | - Ana B Chica
- Experimental Psychology Department, and Brain, Mind, and Behavior Research Center (CIMCYC-UGR), University of Granada, Granada, Spain
| | - Paolo Bartolomeo
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, APHP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Michel Thiebaut de Schotten
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, Bordeaux, France.
- Brain Connectivity and Behaviour Laboratory, Sorbonne Université, Paris, France.
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4
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Robert S, Granovetter MC, Patterson C, Behrmann M. Hemispheric functional organization, as revealed by naturalistic neuroimaging, in pediatric epilepsy patients with cortical resections. Proc Natl Acad Sci U S A 2024; 121:e2317458121. [PMID: 38950362 PMCID: PMC11252739 DOI: 10.1073/pnas.2317458121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 05/14/2024] [Indexed: 07/03/2024] Open
Abstract
Functional changes in the pediatric brain following neural injuries attest to remarkable feats of plasticity. Investigations of the neurobiological mechanisms that underlie this plasticity have largely focused on activation in the penumbra of the lesion or in contralesional, homotopic regions. Here, we adopt a whole-brain approach to evaluate the plasticity of the cortex in patients with large unilateral cortical resections due to drug-resistant childhood epilepsy. We compared the functional connectivity (FC) in patients' preserved hemisphere with the corresponding hemisphere of matched controls as they viewed and listened to a movie excerpt in a functional magnetic resonance imaging (fMRI) scanner. The preserved hemisphere was segmented into 180 and 200 parcels using two different anatomical atlases. We calculated all pairwise multivariate statistical dependencies between parcels, or parcel edges, and between 22 and 7 larger-scale functional networks, or network edges, aggregated from the smaller parcel edges. Both the left and right hemisphere-preserved patient groups had widespread reductions in FC relative to matched controls, particularly for within-network edges. A case series analysis further uncovered subclusters of patients with distinctive edgewise changes relative to controls, illustrating individual postoperative connectivity profiles. The large-scale differences in networks of the preserved hemisphere potentially reflect plasticity in the service of maintained and/or retained cognitive function.
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Affiliation(s)
- Sophia Robert
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA15213
- The Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA15213
| | - Michael C. Granovetter
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA15213
- The Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA15213
- School of Medicine, University of Pittsburgh, Pittsburgh, PA15213
| | - Christina Patterson
- Department of Pediatrics, Division of Child Neurology, University of Pittsburgh, Pittsburgh, PA15213
| | - Marlene Behrmann
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA15213
- The Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA15213
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA15219
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5
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Toba MN, Malkinson TS, Howells H, Mackie MA, Spagna A. Same, Same but Different? A Multi-Method Review of the Processes Underlying Executive Control. Neuropsychol Rev 2024; 34:418-454. [PMID: 36967445 DOI: 10.1007/s11065-023-09577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 09/26/2022] [Indexed: 03/29/2023]
Abstract
Attention, working memory, and executive control are commonly considered distinct cognitive functions with important reciprocal interactions. Yet, longstanding evidence from lesion studies has demonstrated both overlap and dissociation in their behavioural expression and anatomical underpinnings, suggesting that a lower dimensional framework could be employed to further identify processes supporting goal-directed behaviour. Here, we describe the anatomical and functional correspondence between attention, working memory, and executive control by providing an overview of cognitive models, as well as recent data from lesion studies, invasive and non-invasive multimodal neuroimaging and brain stimulation. We emphasize the benefits of considering converging evidence from multiple methodologies centred on the identification of brain mechanisms supporting goal-driven behaviour. We propose that expanding on this approach should enable the construction of a comprehensive anatomo-functional framework with testable new hypotheses, and aid clinical neuroscience to intervene on impairments of executive functions.
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Affiliation(s)
- Monica N Toba
- Laboratory of Functional Neurosciences (UR UPJV 4559), University Hospital of Amiens and University of Picardie Jules Verne, Amiens, France.
- CHU Amiens Picardie - Site Sud, Centre Universitaire de Recherche en Santé, Avenue René Laënnec, 80054, Amiens Cedex 1, France.
| | - Tal Seidel Malkinson
- Paris Brain Institute, ICM, Hôpital de La Pitié-Salpêtrière, Sorbonne Université, Inserm U 1127, CNRS UMR 7225, 75013, Paris, France
- Université de Lorraine, CRAN, F-54000, Nancy, France
| | - Henrietta Howells
- Laboratory of Motor Control, Department of Medical Biotechnologies and Translational Medicine, Humanitas Research Hospital, IRCCS, Università Degli Studi Di Milano, Milan, Italy
| | - Melissa-Ann Mackie
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alfredo Spagna
- Department of Psychology, Columbia University, New York, NY, 10025, USA.
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6
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Kaufmann BC, Pastore-Wapp M, Bartolomeo P, Geiser N, Nyffeler T, Cazzoli D. Severity-Dependent Interhemispheric White Matter Connectivity Predicts Poststroke Neglect Recovery. J Neurosci 2024; 44:e1311232024. [PMID: 38565290 PMCID: PMC11112644 DOI: 10.1523/jneurosci.1311-23.2024] [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: 07/13/2023] [Revised: 12/15/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
Left-sided spatial neglect is a very common and challenging issue after right-hemispheric stroke, which strongly and negatively affects daily living behavior and recovery of stroke survivors. The mechanisms underlying recovery of spatial neglect remain controversial, particularly regarding the involvement of the intact, contralesional hemisphere, with potential contributions ranging from maladaptive to compensatory. In the present prospective, observational study, we assessed neglect severity in 54 right-hemispheric stroke patients (32 male; 22 female) at admission to and discharge from inpatient neurorehabilitation. We demonstrate that the interaction of initial neglect severity and spared white matter (dis)connectivity resulting from individual lesions (as assessed by diffusion tensor imaging, DTI) explains a significant portion of the variability of poststroke neglect recovery. In mildly impaired patients, spared structural connectivity within the lesioned hemisphere is sufficient to attain good recovery. Conversely, in patients with severe impairment, successful recovery critically depends on structural connectivity within the intact hemisphere and between hemispheres. These distinct patterns, mediated by their respective white matter connections, may help to reconcile the dichotomous perspectives regarding the role of the contralesional hemisphere as exclusively compensatory or not. Instead, they suggest a unified viewpoint wherein the contralesional hemisphere can - but must not necessarily - assume a compensatory role. This would depend on initial impairment severity and on the available, spared structural connectivity. In the future, our findings could serve as a prognostic biomarker for neglect recovery and guide patient-tailored therapeutic approaches.
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Affiliation(s)
- Brigitte C Kaufmann
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris 75013, France
- Neurocenter, Luzerner Kantonsspital, Lucerne 6016, Switzerland
| | - Manuela Pastore-Wapp
- Neurocenter, Luzerner Kantonsspital, Lucerne 6016, Switzerland
- ARTORG Center for Biomedical Engineering Research, Gerontechnology and Rehabilitation Group, University of Bern, Bern 3010, Switzerland
| | - Paolo Bartolomeo
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris 75013, France
| | - Nora Geiser
- Neurocenter, Luzerner Kantonsspital, Lucerne 6016, Switzerland
- ARTORG Center for Biomedical Engineering Research, Gerontechnology and Rehabilitation Group, University of Bern, Bern 3010, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern 3012, Switzerland
| | - Thomas Nyffeler
- Neurocenter, Luzerner Kantonsspital, Lucerne 6016, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern 3012, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern 3010, Switzerland
| | - Dario Cazzoli
- Neurocenter, Luzerner Kantonsspital, Lucerne 6016, Switzerland
- ARTORG Center for Biomedical Engineering Research, Gerontechnology and Rehabilitation Group, University of Bern, Bern 3010, Switzerland
- Department of Psychology, University of Bern, Bern 3012, Switzerland
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7
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Sanchez-Lopez J, Cardobi N, Parisi G, Savazzi S, Marzi CA. Role of corpus callosum in unconscious vision. Neuropsychologia 2024; 196:108839. [PMID: 38401630 PMCID: PMC11004727 DOI: 10.1016/j.neuropsychologia.2024.108839] [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: 07/19/2023] [Revised: 02/01/2024] [Accepted: 02/21/2024] [Indexed: 02/26/2024]
Abstract
The existence of unconscious visually triggered behavior in patients with cortical blindness (e.g., homonymous hemianopia) has been amply demonstrated and the neural bases of this phenomenon have been thoroughly studied. However, a crosstalk between the two hemispheres as a possible mechanism of unconscious or partially conscious vision has not been so far considered. Thus, the aim of this study was to assess the relationship between structural and functional properties of the corpus callosum (CC), as shown by probabilistic tractography (PT), behavioral detection/discrimination performance and level of perceptual awareness in the blind field of patients with hemianopia. Twelve patients were tested in two tasks with black-and-white visual square-wave gratings, one task of movement and the other of orientation. The stimuli were lateralized to one hemifield either intact or blind. A PT analysis was carried out on MRI data to extract fiber properties along the CC (genu, body, and splenium). Compared with a control group of participants without brain damage, patients showed lower FA values in all three CC sections studied. For the intact hemifield we found a significant correlation between PT values and visual detection/discrimination accuracy. For the blind hemifield the level of perceptual awareness correlated with PT values for all three CC sections in the movement task. Importantly, significant differences in all three CC sections were found also between patients with above-vs. chance detection/discrimination performance while differences in the genu were found between patients with and without perceptual awareness. Overall, our study provides evidence that the properties of CC fibers are related to the presence of unconscious stimulus detection/discrimination and to hints of perceptual awareness for stimulus presentation to the blind hemifield. These results underline the importance of information exchange between the damaged and the healthy hemisphere for possible partial or full recovery from hemianopia.
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Affiliation(s)
- Javier Sanchez-Lopez
- Escuela Nacional de Estudios Superiores Unidad Juriquilla, Universidad Nacional Autonoma de Mexico, Queretaro, Mexico; Department of Neuroscience, Biomedicine and Movement, University of Verona, Italy.
| | - Nicolo Cardobi
- Azienda Ospedaliera Universitaria Integrata Verona, Italy.
| | - Giorgia Parisi
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Italy; Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy.
| | - Silvia Savazzi
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Italy; Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy.
| | - Carlo A Marzi
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Italy.
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8
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Latifi S, Carmichael ST. The emergence of multiscale connectomics-based approaches in stroke recovery. Trends Neurosci 2024; 47:303-318. [PMID: 38402008 DOI: 10.1016/j.tins.2024.01.003] [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: 08/22/2023] [Revised: 12/31/2023] [Accepted: 01/21/2024] [Indexed: 02/26/2024]
Abstract
Stroke is a leading cause of adult disability. Understanding stroke damage and recovery requires deciphering changes in complex brain networks across different spatiotemporal scales. While recent developments in brain readout technologies and progress in complex network modeling have revolutionized current understanding of the effects of stroke on brain networks at a macroscale, reorganization of smaller scale brain networks remains incompletely understood. In this review, we use a conceptual framework of graph theory to define brain networks from nano- to macroscales. Highlighting stroke-related brain connectivity studies at multiple scales, we argue that multiscale connectomics-based approaches may provide new routes to better evaluate brain structural and functional remapping after stroke and during recovery.
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Affiliation(s)
- Shahrzad Latifi
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA
| | - S Thomas Carmichael
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.
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9
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Mazzi C, Mele S, Bagattini C, Sanchez-Lopez J, Savazzi S. Coherent activity within and between hemispheres: cortico-cortical connectivity revealed by rTMS of the right posterior parietal cortex. Front Hum Neurosci 2024; 18:1362742. [PMID: 38516308 PMCID: PMC10954802 DOI: 10.3389/fnhum.2024.1362742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/23/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction Low frequency (1 Hz) repetitive transcranial stimulation (rTMS) applied over right posterior parietal cortex (rPPC) has been shown to reduce cortical excitability both of the stimulated area and of the interconnected contralateral homologous areas. In the present study, we investigated the whole pattern of intra- and inter-hemispheric cortico-cortical connectivity changes induced by rTMS over rPPC. Methods To do so, 14 healthy participants underwent resting state EEG recording before and after 30 min of rTMS at 1 Hz or sham stimulation over the rPPC (electrode position P6). Real stimulation was applied at 90% of motor threshold. Coherence values were computed on the electrodes nearby the stimulated site (i.e., P4, P8, and CP6) considering all possible inter- and intra-hemispheric combinations for the following frequency bands: delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-12Hz), low beta (12-20 Hz), high beta (20-30 Hz), and gamma (30-50 Hz). Results and discussion Results revealed a significant increase in coherence in delta, theta, alpha and beta frequency bands between rPPC and the contralateral homologous sites. Moreover, an increase in coherence in theta, alpha, beta and gamma frequency bands was found between rPPC and right frontal sites, reflecting the activation of the fronto-parietal network within the right hemisphere. Summarizing, subthreshold rTMS over rPPC revealed cortico-cortical inter- and intra-hemispheric connectivity as measured by the increase in coherence among these areas. Moreover, the present results further confirm previous evidence indicating that the increase of coherence values is related to intra- and inter-hemispheric inhibitory effects of rTMS. These results can have implications for devising evidence-based rehabilitation protocols after stroke.
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Affiliation(s)
- Chiara Mazzi
- Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sonia Mele
- Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Bagattini
- Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Section of Neurosurgery, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Javier Sanchez-Lopez
- Escuela Nacional de Estudios Superiores Unidad Juriquilla, Universidad Nacional Autonoma de Mexico, Santiago de Querétaro, Mexico
| | - Silvia Savazzi
- Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Zigiotto L, Amorosino G, Saviola F, Jovicich J, Annicchiarico L, Rozzanigo U, Olivetti E, Avesani P, Sarubbo S. Spontaneous unilateral spatial neglect recovery after brain tumour resection: A multimodal diffusion and rs-fMRI case report. J Neuropsychol 2024; 18 Suppl 1:91-114. [PMID: 37431064 DOI: 10.1111/jnp.12339] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/25/2023] [Indexed: 07/12/2023]
Abstract
Patients with unilateral spatial neglect (USN) are unable to explore or to report stimuli presented in the left personal and extra-personal space. USN is usually caused by lesion of the right parietal lobe: nowadays, it is also clear the key role of structural connections (the second and the third branch of the right Superior Longitudinal Fasciculus, respectively, SLF II and III) and functional networks (Dorsal and Ventral Attention Network, respectively, DAN and VAN) in USN. In this multimodal case report, we have merged those structural and functional information derived from a patient with a right parietal lobe tumour and USN before surgery. Functional, structural and neuropsychological data were also collected 6 months after surgery, when the USN was spontaneously recovered. Diffusion metrics and Functional Connectivity (FC) of the right SLF and DAN, before and after surgery, were compared with the same data of a patient with a tumour in a similar location, but without USN, and with a control sample. Results indicate an impairment in the right SLF III and a reduction of FC of the right DAN in patients with USN before surgery compared to controls; after surgery, when USN was recovered, patient's diffusion metrics and FC showed no differences compared to the controls. This single case and its multimodal approach reinforce the crucial role of the right SLF III and DAN in the development and recovery of egocentric and allocentric extra-personal USN, highlighting the need to preserve these structural and functional areas during brain surgery.
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Affiliation(s)
- Luca Zigiotto
- Department of Neurosurgery, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Structural and Functional Connectivity Lab Project, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Department of Psychology, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Gabriele Amorosino
- Neuroinformatics Laboratory (NILab), Bruno Kessler Foundation (FBK), Trento, Italy
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Francesca Saviola
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Jorge Jovicich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Luciano Annicchiarico
- Department of Neurosurgery, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Structural and Functional Connectivity Lab Project, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Umberto Rozzanigo
- Department of Neuroradiology, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Emanuele Olivetti
- Neuroinformatics Laboratory (NILab), Bruno Kessler Foundation (FBK), Trento, Italy
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Paolo Avesani
- Neuroinformatics Laboratory (NILab), Bruno Kessler Foundation (FBK), Trento, Italy
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Silvio Sarubbo
- Department of Neurosurgery, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Structural and Functional Connectivity Lab Project, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
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11
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Namgung E, Kim YH, Lee EJ, Sasaki Y, Watanabe T, Kang DW. Functional connectivity interacts with visual perceptual learning for visual field recovery in chronic stroke. Sci Rep 2024; 14:3247. [PMID: 38332042 PMCID: PMC10853510 DOI: 10.1038/s41598-024-52778-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024] Open
Abstract
A reciprocal relationship between perceptual learning and functional brain changes towards perceptual learning effectiveness has been demonstrated previously; however, the underlying neural correlates remain unclear. Further, visual perceptual learning (VPL) is implicated in visual field defect (VFD) recovery following chronic stroke. We investigated resting-state functional connectivity (RSFC) in the visual cortices associated with mean total deviation (MTD) scores for VPL-induced VFD recovery in chronic stroke. Patients with VFD due to chronic ischemic stroke in the visual cortex received 24 VPL training sessions over 2 months, which is a dual discrimination task of orientation and letters. At baseline and two months later, the RSFC in the ipsilesional, interhemispheric, and contralesional visual cortices and MTD scores in the affected hemi-field were assessed. Interhemispheric visual RSFC at baseline showed the strongest correlation with MTD scores post-2-month VPL training. Notably, only the subgroup with high baseline interhemispheric visual RSFC showed significant VFD improvement following the VPL training. The interactions between the interhemispheric visual RSFC at baseline and VPL led to improvement in MTD scores and largely influenced the degree of VFD recovery. The interhemispheric visual RSFC at baseline could be a promising brain biomarker for the effectiveness of VPL-induced VFD recovery.
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Affiliation(s)
- Eun Namgung
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea
| | | | - Eun-Jae Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yuka Sasaki
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, USA
| | - Takeo Watanabe
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, USA
| | - Dong-Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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12
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Kaļva K, Zdanovskis N, Šneidere K, Kostiks A, Karelis G, Platkājis A, Stepens A. Whole Brain and Corpus Callosum Fractional Anisotropy Differences in Patients with Cognitive Impairment. Diagnostics (Basel) 2023; 13:3679. [PMID: 38132263 PMCID: PMC10742911 DOI: 10.3390/diagnostics13243679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/20/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Diffusion tensor imaging (DTI) is an MRI analysis method that could help assess cognitive impairment (CI) in the ageing population more accurately. In this research, we evaluated fractional anisotropy (FA) of whole brain (WB) and corpus callosum (CC) in patients with normal cognition (NC), mild cognitive impairment (MCI), and moderate/severe cognitive impairment (SCI). In total, 41 participants were included in a cross-sectional study and divided into groups based on Montreal Cognitive Assessment (MoCA) scores (NC group, nine participants, MCI group, sixteen participants, and SCI group, sixteen participants). All participants underwent an MRI examination that included a DTI sequence. FA values between the groups were assessed by analysing FA value and age normative percentile. We did not find statistically significant differences between the groups when analysing CC FA values. Both approaches showed statistically significant differences in WB FA values between the MCI-SCI and MCI-NC groups, where the MCI group participants showed the highest mean FA and highest mean FA normative percentile results in WB.
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Affiliation(s)
- Kalvis Kaļva
- Department of Radiology, Riga Stradins University, LV-1007 Riga, Latvia; (K.K.)
- Department of Radiology, Riga East Clinical University Hospital, LV-1038 Riga, Latvia
| | - Nauris Zdanovskis
- Department of Radiology, Riga Stradins University, LV-1007 Riga, Latvia; (K.K.)
- Department of Radiology, Riga East Clinical University Hospital, LV-1038 Riga, Latvia
- Military Medicine Research and Study Centre, Riga Stradins University, LV-1007 Riga, Latvia
| | - Kristīne Šneidere
- Military Medicine Research and Study Centre, Riga Stradins University, LV-1007 Riga, Latvia
- Department of Health Psychology and Paedagogy, Riga Stradins University, LV-1007 Riga, Latvia
| | - Andrejs Kostiks
- Department of Neurology and Neurosurgery, Riga East University Hospital, LV-1038 Riga, Latvia; (A.K.)
| | - Guntis Karelis
- Department of Neurology and Neurosurgery, Riga East University Hospital, LV-1038 Riga, Latvia; (A.K.)
- Department of Infectology, Riga Stradins University, LV-1007 Riga, Latvia
| | - Ardis Platkājis
- Department of Radiology, Riga Stradins University, LV-1007 Riga, Latvia; (K.K.)
- Department of Radiology, Riga East Clinical University Hospital, LV-1038 Riga, Latvia
| | - Ainārs Stepens
- Military Medicine Research and Study Centre, Riga Stradins University, LV-1007 Riga, Latvia
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13
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Guidali G, Bagattini C, De Matola M, Brignani D. Influence of frontal-to-parietal connectivity in pseudoneglect: A cortico-cortical paired associative stimulation study. Cortex 2023; 169:50-64. [PMID: 37862830 DOI: 10.1016/j.cortex.2023.08.012] [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: 06/09/2023] [Revised: 07/27/2023] [Accepted: 08/23/2023] [Indexed: 10/22/2023]
Abstract
Pseudoneglect is a set of visuospatial biases that entails a behavioral advantage for stimuli appearing in the left hemifield compared to the right one. Although right hemisphere dominance for visuospatial processing has been invoked to explain this phenomenon, its neurophysiological mechanisms are still debated, and the role of intra- and inter-hemispheric connectivity is yet to be defined. The present study explored the possibility of modulating pseudoneglect in healthy participants through a cortico-cortical paired associative stimulation protocol (ccPAS): a non-invasive brain stimulation protocol that manipulates the interplay between brain regions through the repeated, time-locked coupling of two transcranial magnetic stimulation (TMS) pulses. In the first experiment, healthy participants underwent a frontal-to-parietal (FP) and a parietal-to-frontal (PF) ccPAS. In the FP protocol, the first TMS pulse targeted the right frontal eye field (FEF), and the second pulse the right inferior parietal lobule (IPL), two critical areas for visuospatial and attentional processing. In the PF condition, the order of the pulses was reversed. In both protocols, the inter-stimulus interval (ISI) was 10 ms. Before and after stimulation, pseudoneglect was assessed with a landmark task and a manual line bisection task. A second experiment controlled for ccPAS timing dependency by testing FP-ccPAS with a longer ISI of 100 ms. Results showed that after administering the FP-ccPAS with the ISI of 10 ms, participants' leftward bias in the landmark task increased significantly, with no effects in the manual line bisection task. The other two protocols tested were ineffective. Our findings showed that ccPAS could be used to modulate pseudoneglect by exploiting frontal-to-parietal connectivity, possibly through increased top-down attentional control. FP-ccPAS could represent a promising tool to investigate connectivity properties within visuospatial and attentional networks in the healthy and as a potential rehabilitation protocol in patients suffering from severe visuospatial pathologies.
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Affiliation(s)
- Giacomo Guidali
- Neurophysiology Lab, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Chiara Bagattini
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Matteo De Matola
- Neurophysiology Lab, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Debora Brignani
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
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14
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Kaufmann BC, Cazzoli D, Nyffeler T, Bartolomeo P. Causal evidence for the multiple-demand brain network: it takes three to tango. Brain 2023; 146:e115-e116. [PMID: 37352892 DOI: 10.1093/brain/awad217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/18/2023] [Indexed: 06/25/2023] Open
Affiliation(s)
- Brigitte C Kaufmann
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, AP-HP, Hôpital de La Pitié-Salpêtrière, 75013 Paris, France
| | - Dario Cazzoli
- Neurocenter, Luzerner Kantonsspital, 6000 Lucerne, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland
- Department of Psychology, University of Bern, 3008 Bern, Switzerland
| | - Thomas Nyffeler
- Neurocenter, Luzerner Kantonsspital, 6000 Lucerne, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, 3008 Bern, Switzerland
| | - Paolo Bartolomeo
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, AP-HP, Hôpital de La Pitié-Salpêtrière, 75013 Paris, France
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15
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Lunven M, Toba MN, Bartolomeo P. Prism adaptation therapy in spatial neglect: The importance of connectional anatomy. Neuropsychologia 2023; 188:108640. [PMID: 37423424 DOI: 10.1016/j.neuropsychologia.2023.108640] [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: 06/14/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
The meta-analysis conducted by Székely et al. described the lack of beneficial effect of prism adaptation in neglect patients. The authors concluded that the results did "not support the routine use of prism adaptation as a therapy for spatial neglect". However, a possible nuance to this conclusion could be that the response (or lack thereof) of neglect patients to prism adaptation may actually depend on the connectional anatomy of their lesion. We develop this idea in our commentary, in order to offer a more balanced perspective on the implications of the findings obtained by Székely et al.
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Affiliation(s)
- Marine Lunven
- Département D'Etudes Cognitives, École Normale Supérieure, PSL University, 75005, Paris, France; University Paris Est Creteil, INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, F-94010, Creteil, France
| | - Monica N Toba
- Laboratory of Functional Neurosciences (UR UPJV 4559), University of Picardy Jules Verne and University Hospital of Amiens, Amiens, France; Sorbonne Université, Inserm U 1127, CNRS UMR 7225, Paris Brain Institute, ICM, Hôpital de La Pitié-Salpêtrière, 75013, Paris, France
| | - Paolo Bartolomeo
- Sorbonne Université, Inserm U 1127, CNRS UMR 7225, Paris Brain Institute, ICM, Hôpital de La Pitié-Salpêtrière, 75013, Paris, France.
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16
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Rosenzopf H, Klingbeil J, Wawrzyniak M, Röhrig L, Sperber C, Saur D, Karnath HO. Thalamocortical disconnection involved in pusher syndrome. Brain 2023; 146:3648-3661. [PMID: 36943319 DOI: 10.1093/brain/awad096] [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: 10/21/2022] [Revised: 02/13/2023] [Accepted: 03/02/2023] [Indexed: 03/23/2023] Open
Abstract
The presence of both isolated thalamic and isolated cortical lesions have been reported in the context of pusher syndrome-a disorder characterized by a disturbed perception of one's own upright body posture, following unilateral left- or right-sided stroke. In recent times, indirect quantification of functional and structural disconnection increases the knowledge derived from focal brain lesions by inferring subsequent brain network damage from the respective lesion. We applied both measures to a sample of 124 stroke patients to investigate brain disconnection in pusher syndrome. Our results suggest a hub-like function of the posterior and lateral portions of the thalamus in the perception of one's own postural upright. Lesion network symptom mapping investigating functional disconnection indicated cortical diaschisis in cerebellar, frontal, parietal and temporal areas in patients with thalamic lesions suffering from pusher syndrome, but there was no evidence for functional diaschisis in pusher patients with cortical stroke and no evidence for the convergence of thalamic and cortical lesions onto a common functional network. Structural disconnection mapping identified posterior thalamic disconnection to temporal, pre-, post- and paracentral regions. Fibre tracking between the thalamic and cortical pusher lesion hotspots indicated that in cortical lesions of patients with pusher syndrome, it is disconnectivity to the posterior thalamus caused by accompanying white matter damage, rather than the direct cortical lesions themselves, that lead to the emergence of pusher syndrome. Our analyses thus offer the first evidence for a direct thalamo-cortical (or cortico-thalamic) interconnection and, more importantly, shed light on the location of the respective thalamo-cortical disconnections. Pusher syndrome seems to be a consequence of direct damage or of disconnection of the posterior thalamus.
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Affiliation(s)
- Hannah Rosenzopf
- Center of Neurology, Division of Neuropsychology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Julian Klingbeil
- Neuroimaging Lab, Department of Neurology, University of Leipzig, 04103 Leipzig, Germany
| | - Max Wawrzyniak
- Neuroimaging Lab, Department of Neurology, University of Leipzig, 04103 Leipzig, Germany
| | - Lisa Röhrig
- Center of Neurology, Division of Neuropsychology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Christoph Sperber
- Center of Neurology, Division of Neuropsychology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Dorothee Saur
- Neuroimaging Lab, Department of Neurology, University of Leipzig, 04103 Leipzig, Germany
| | - Hans-Otto Karnath
- Center 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, SC 29208, USA
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17
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Ueda M, Yuri T, Ueno K, Ishii R, Naito Y. The Neurophysiological Features Associated with Unilateral Spatial Neglect Recovery: A Scoping Review. Brain Topogr 2023; 36:631-643. [PMID: 37410274 DOI: 10.1007/s10548-023-00980-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 06/19/2023] [Indexed: 07/07/2023]
Abstract
The purpose of this scoping review is to provide updated information on the neural basis and neurophysiological features associated with unilateral spatial neglect (USN) recovery. We applied the Preferred Reporting Systems for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) framework and identified 16 relevant papers from the databases. Critical appraisal was performed by two independent reviewers using a standardized appraisal instrument developed by the PRISMA-ScR. We identified and categorized investigation methods for the neural basis and neurophysiological features of USN recovery after stroke using magnetic resonance imaging (MRI), functional MRI, and electroencephalography (EEG). This review found two brain-level mechanisms underlying USN recovery at the behavioral level. These include the absence of stroke-related damage to the right ventral attention network during the acute phase and compensatory recruitment of analogous areas of the undamaged opposite hemisphere and prefrontal cortex during visual search tasks in the subacute or later phases. However, the relationship between the neural and neurophysiological findings and improvements in USN-related activities of daily living remains unknown. This review adds to the growing body of evidence regarding the neural mechanisms underlying USN recovery.
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Affiliation(s)
- Masaya Ueda
- Demartment of Occupational Therapy, Graduate School of Rehabilitation Science, Osaka Metropolitan University, Osaka, Japan.
| | - Takuma Yuri
- Department of Occupational Therapy, Kyoto Tachibana University, Kyoto, Japan
| | - Keita Ueno
- Demartment of Occupational Therapy, Graduate School of Rehabilitation Science, Osaka Metropolitan University, Osaka, Japan
| | - Ryouhei Ishii
- Demartment of Occupational Therapy, Graduate School of Rehabilitation Science, Osaka Metropolitan University, Osaka, Japan
- Department of Psychiatry, Medical School, Osaka University, Osaka, Japan
| | - Yasuo Naito
- Demartment of Occupational Therapy, Graduate School of Rehabilitation Science, Osaka Metropolitan University, Osaka, Japan
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18
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Smits AR, van Zandvoort MJE, Ramsey NF, de Haan EHF, Raemaekers M. Reliability and validity of DTI-based indirect disconnection measures. Neuroimage Clin 2023; 39:103470. [PMID: 37459698 PMCID: PMC10368919 DOI: 10.1016/j.nicl.2023.103470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023]
Abstract
White matter connections enable the interaction within and between brain networks. Brain lesions can cause structural disconnections that disrupt networks and thereby cognitive functions supported by them. In recent years, novel methods have been developed to quantify the extent of structural disconnection after focal lesions, using tractography data from healthy controls. These methods, however, are indirect and their reliability and validity have yet to be fully established. In this study, we present our implementation of this approach, in a tool supplemented by uncertainty metrics for the predictions overall and at voxel-level. These metrics give an indication of the reliability and are used to compare predictions with direct measures from patients' diffusion tensor imaging (DTI) data in a sample of 95 first-ever stroke patients. Results show that, except for small lesions, the tool can predict fiber loss with high reliability and compares well to direct patient DTI estimates. Clinical utility of the method was demonstrated using lesion data from a subset of patients suffering from hemianopia. Both tract-based measures outperformed lesion localization in mapping visual field defects and showed a network consistent with the known anatomy of the visual system. This study offers an important contribution to the validation of structural disconnection mapping. We show that indirect measures of structural disconnection can be a reliable and valid substitute for direct estimations of fiber loss after focal lesions. Moreover, based on these results, we argue that indirect structural disconnection measures may even be preferable to lower-quality single subject diffusion MRI when based on high-quality healthy control datasets.
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Affiliation(s)
- A R Smits
- UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, the Netherlands; Department of Psychology, University of Amsterdam, the Netherlands.
| | - M J E van Zandvoort
- UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, the Netherlands; Department of Experimental Psychology, Helmholtz Institute, Utrecht University, the Netherlands
| | - N F Ramsey
- UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, the Netherlands
| | - E H F de Haan
- Department of Psychology, University of Amsterdam, the Netherlands; St. Hugh's College, Oxford University, United Kingdom
| | - M Raemaekers
- UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, the Netherlands
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19
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Carter AR, Barrett A. Recent advances in treatment of spatial neglect: networks and neuropsychology. Expert Rev Neurother 2023; 23:587-601. [PMID: 37273197 PMCID: PMC10740348 DOI: 10.1080/14737175.2023.2221788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Spatial neglect remains an underdiagnosed and undertreated consequence of stroke that imposes significant disability. A growing appreciation of brain networks involved in spatial cognition is helping us to develop a mechanistic understanding of different therapies under development. AREAS COVERED This review focuses on neuromodulation of brain networks for the treatment of spatial neglect after stroke, using evidence-based approaches including 1) Cognitive strategies that are more likely to impact frontal lobe executive function networks; 2) Visuomotor adaptation, which may depend on the integrity of parietal and parieto- and subcortical-frontal connections and the presence of a particular subtype of neglect labeled Aiming neglect; 3) Non-invasive brain stimulation that may modulate relative levels of activity of the two hemispheres and depend on corpus callosum connectivity; and 4) Pharmacological modulation that may exert its effect primarily via right-lateralized networks more closely involved in arousal. EXPERT OPINION Despite promising results from individual studies, significant methodological heterogeneity between trials weakened conclusions drawn from meta-analyses. Improved classification of spatial neglect subtypes will benefit research and clinical care. Understanding the brain network mechanisms of different treatments and different types of spatial neglect will make possible a precision medicine treatment approach.
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Affiliation(s)
- Alex R. Carter
- Department of Neurology, Department of Orthopedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - A.M. Barrett
- UMass Chan Medical School and UMass Memorial Healthcare, Worcester, MA, USA
- Central Western MA VA Healthcare System, Worcester, MA, USA
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20
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Ebisu T, Fukunaga M, Murase T, Matsuura T, Tomura N, Miyazaki Y, Osaki S, Okada T, Higuchi T, Umeda M. Functional Connectivity Pattern Using Resting-state fMRI as an Assessment Tool for Spatial Neglect during the Recovery Stage of Stroke: A Pilot Study. Magn Reson Med Sci 2023; 22:313-324. [PMID: 35370261 PMCID: PMC10449554 DOI: 10.2463/mrms.mp.2022-0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/19/2022] [Indexed: 08/26/2023] Open
Abstract
PURPOSE To determine if functional connectivity measured with resting-state functional MRI could be used as a tool to assess unilateral spatial neglect during stroke recovery. METHODS Resting-state functional MRI was performed on 13 stroke patients with lesions in the right cerebral hemisphere and 31 healthy subjects. The functional connectivity score was defined as a correlation of a target region with the right inferior parietal lobule. Spatial neglect was measured with a behavioral inattention test. RESULTS First, the functional connectivity scores between the right inferior parietal lobule and right inferior frontal gyrus, including the opercular and triangular parts, were significantly decreased in stroke patients with unilateral spatial neglect compared with patients without unilateral spatial neglect and were significantly correlated with the behavioral inattention test score. Second, the functional connectivity scores between the bilateral inferior parietal lobules were also significantly decreased in patients with unilateral spatial neglect compared with patients without unilateral spatial neglect and were significantly correlated with the behavioral inattention test score. Third, negative functional connectivity scores between the right inferior parietal lobule and bilateral medial orbitofrontal cortexes, which are related to the default mode network, were detected in patients without unilateral spatial neglect in contrast to a reduction of this negative tendency in patients with unilateral spatial neglect. The functional connectivity scores between these regions were significantly different between patients with and without unilateral spatial neglect and were negatively correlated with the behavioral inattention test score. CONCLUSION Though still in the pilot research stage and using a small number of cases, our findings are consistent with the hypothesis that functional connectivity maps generated with resting-state functional MRI may be used as a tool to evaluate unilateral spatial neglect during stroke recovery.
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Affiliation(s)
- Toshihiko Ebisu
- Division of Rehabilitation Medicine, Kansai Electric Power Medical Research Institute, Osaka, Osaka, Japan
- Department of Rehabilitation Medicine, Kansai Electric Power Hospital, Osaka, Osaka, Japan
| | - Masaki Fukunaga
- Division of Cerebral Integration, National Institute for Physiological Sciences, Okazaki, Aichi, Japan
| | - Tomokazu Murase
- Medical Education and Research Center, Meiji University of Integrative Medicine, Nantan, Kyoto, Japan
| | - Toyoshi Matsuura
- Department of Radiology, Kansai Electric Power Hospital, Osaka, Osaka, Japan
| | - Naoya Tomura
- Department of Radiology, Kansai Electric Power Hospital, Osaka, Osaka, Japan
| | - Yasuhiro Miyazaki
- Division of Rehabilitation Medicine, Kansai Electric Power Medical Research Institute, Osaka, Osaka, Japan
- Department of Rehabilitation Medicine, Kansai Electric Power Hospital, Osaka, Osaka, Japan
| | - Shinpei Osaki
- Division of Rehabilitation Medicine, Kansai Electric Power Medical Research Institute, Osaka, Osaka, Japan
- Department of Rehabilitation Medicine, Kansai Electric Power Hospital, Osaka, Osaka, Japan
| | - Tsutomu Okada
- Department of Radiology, Kansai Electric Power Hospital, Osaka, Osaka, Japan
| | - Toshihiro Higuchi
- Department of Neurosurgery, Meiji University of Integrative Medicine, Nantan, Kyoto, Japan
| | - Masahiro Umeda
- Medical Education and Research Center, Meiji University of Integrative Medicine, Nantan, Kyoto, Japan
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21
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Kernbach JM, Hartwigsen G, Lim JS, Bae HJ, Yu KH, Schlaug G, Bonkhoff A, Rost NS, Bzdok D. Bayesian stroke modeling details sex biases in the white matter substrates of aphasia. Commun Biol 2023; 6:354. [PMID: 37002267 PMCID: PMC10066402 DOI: 10.1038/s42003-023-04733-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
Ischemic cerebrovascular events often lead to aphasia. Previous work provided hints that such strokes may affect women and men in distinct ways. Women tend to suffer strokes with more disabling language impairment, even if the lesion size is comparable to men. In 1401 patients, we isolate data-led representations of anatomical lesion patterns and hand-tailor a Bayesian analytical solution to carefully model the degree of sex divergence in predicting language outcomes ~3 months after stroke. We locate lesion-outcome effects in the left-dominant language network that highlight the ventral pathway as a core lesion focus across different tests of language performance. We provide detailed evidence for sex-specific brain-behavior associations in the domain-general networks associated with cortico-subcortical pathways, with unique contributions of the fornix in women and cingular fiber bundles in men. Our collective findings suggest diverging white matter substrates in how stroke causes language deficits in women and men. Clinically acknowledging such sex disparities has the potential to improve personalized treatment for stroke patients worldwide.
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Affiliation(s)
- Julius M Kernbach
- Neurosurgical Artificial Intelligence Laboratory Aachen (NAILA), RWTH Aachen University Hospital, Aachen, Germany
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Music, Neuroimaging, and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Gesa Hartwigsen
- Max Planck Institute for Human Cognitive and Brain Sciences, Lise Meitner Research Group Cognition and Plasticity, Leipzig, Germany
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hee-Joon Bae
- Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Gottfried Schlaug
- Music, Neuroimaging, and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Anna Bonkhoff
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Natalia S Rost
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Danilo Bzdok
- Department of Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute, Faculty of Medicine, School of Computer Science, McGill University, Montreal, QC, Canada.
- Mila - Quebec Artificial Intelligence Institute, Montreal, QC, Canada.
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22
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Bartolomeo P, Seidel Malkinson T. Building models, testing models: Asymmetric roles of SLF III networks?: Comment on "Left and right temporal-parietal junctions (TPJs) as "match/mismatch" hedonic machines: A unifying account of TPJ function" by Doricchi et al. Phys Life Rev 2023; 44:70-72. [PMID: 36543073 DOI: 10.1016/j.plrev.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Paolo Bartolomeo
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France.
| | - Tal Seidel Malkinson
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
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23
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Moore MJ, Milosevich E, Mattingley JB, Demeyere N. The neuroanatomy of visuospatial neglect: A systematic review and analysis of lesion-mapping methodology. Neuropsychologia 2023; 180:108470. [PMID: 36621594 DOI: 10.1016/j.neuropsychologia.2023.108470] [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: 09/28/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
While visuospatial neglect is commonly associated with damage to the right posterior parietal cortex, neglect is an anatomically heterogenous syndrome. This project presents a systematic review of 34 lesion-mapping studies reporting on the anatomical correlates of neglect. Specifically, the reported correlates of egocentric versus allocentric, acute versus chronic, personal versus extra-personal, and left versus right hemisphere neglect are summarised. The quality of each included lesion-mapping analysis was then evaluated to identify methodological factors which may help account for the reported variance in correlates of neglect. Overall, the existing literature strongly suggests that egocentric and allocentric neglect represent anatomically dissociable conditions and that the anatomy of these conditions may not be entirely homologous across hemispheres. Studies which have compared the anatomy of acute versus chronic neglect have found that these conditions are associated with distinct lesion loci, while studies comparing the correlates of peripersonal/extrapersonal neglect are split as to whether these neglect subtypes are anatomically dissociable. The included studies employed a wide range of lesion-mapping analysis techniques, each producing results of varying quality and generalisability. This review concludes that the reported underlying anatomical correlates of heterogeneous visuospatial neglect vary considerably. Future, high quality studies are needed to investigate patterns of disconnection associated with clearly defined forms of visuospatial neglect in large and representative samples.
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Affiliation(s)
- Margaret Jane Moore
- Queensland Brain Institute, The University of Queensland, St Lucia, Australia.
| | - Elise Milosevich
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Jason B Mattingley
- Queensland Brain Institute, The University of Queensland, St Lucia, Australia; School of Psychology, The University of Queensland, St Lucia, Australia
| | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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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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Röhrig L, Sperber C, Bonilha L, Rorden C, Karnath HO. Right hemispheric white matter hyperintensities improve the prediction of spatial neglect severity in acute stroke. Neuroimage Clin 2022; 36:103265. [PMID: 36451368 PMCID: PMC9723300 DOI: 10.1016/j.nicl.2022.103265] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/12/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
White matter hyperintensities (WMH) are frequently observed in brain scans of elderly people. They are associated with an increased risk of stroke, cognitive decline, and dementia. However, it is unknown yet if measures of WMH provide information that improve the understanding of poststroke outcome compared to only state-of-the-art stereotaxic structural lesion data. We implemented high-dimensional machine learning models, based on support vector regression, to predict the severity of spatial neglect in 103 acute right hemispheric stroke patients. We found that (1) the additional information of right hemispheric or bilateral voxel-based topographic WMH extent indeed yielded a significant improvement in predicting acute neglect severity (compared to the voxel-based stroke lesion map alone). (2) Periventricular WMH appeared more relevant for prediction than deep subcortical WMH. (3) Among different measures of WMH, voxel-based maps as measures of topographic extent allowed more accurate predictions compared to the use of traditional ordinally assessed visual rating scales (Fazekas-scale, Cardiovascular Health Study-scale). In summary, topographic WMH appear to be a valuable clinical imaging biomarker for predicting the severity of cognitive deficits and bears great potential for rehabilitation guidance of acute stroke patients.
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Affiliation(s)
- Lisa Röhrig
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen 72076, Germany
| | - Christoph Sperber
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen 72076, Germany
| | - Leonardo Bonilha
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
| | - Christopher Rorden
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | - Hans-Otto Karnath
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen 72076, Germany; Department of Psychology, University of South Carolina, Columbia, SC 29208, USA.
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Sheppard SM, Stockbridge MD, Keator LM, Murray LL, Blake ML. The Company Prosodic Deficits Keep Following Right Hemisphere Stroke: A Systematic Review. J Int Neuropsychol Soc 2022; 28:1075-1090. [PMID: 34989666 PMCID: PMC9256864 DOI: 10.1017/s1355617721001302] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of this systematic review was to identify the presence and nature of relationships between specific forms of aprosodia (i.e., expressive and receptive emotional and linguistic prosodic deficits) and other cognitive-communication deficits and disorders in individuals with right hemisphere damage (RHD) due to stroke. METHODS One hundred and ninety articles from 1970 to February 2020 investigating receptive and expressive prosody in patients with relatively focal right hemisphere brain damage were identified via database searches. RESULTS Fourteen articles were identified that met inclusion criteria, passed quality reviews, and included sufficient information about prosody and potential co-occurring deficits. Twelve articles investigated receptive emotional aprosodia, and two articles investigated receptive linguistic aprosodia. Across the included studies, receptive emotional prosody was not systematically associated with hemispatial neglect, but did co-occur with deficits in emotional facial recognition, interpersonal interactions, or emotional semantics. Receptive linguistic processing was reported to co-occur with amusia and hemispatial neglect. No studies were found that investigated the co-occurrence of expressive emotional or linguistic prosodic deficits with other cognitive-communication impairments. CONCLUSIONS This systematic review revealed significant gaps in the research literature regarding the co-occurrence of common right hemisphere disorders with prosodic deficits. More rigorous empirical inquiry is required to identify specific patient profiles based on clusters of deficits associated with right hemisphere stroke. Future research may determine whether the co-occurrences identified are due to shared cognitive-linguistic processes, and may inform the development of evidence-based assessment and treatment recommendations for individuals with cognitive-communication deficits subsequent to RHD.
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Affiliation(s)
- Shannon M. Sheppard
- Communication Sciences and Disorders, Chapman University, Irvine, CA, USA
- Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Lynsey M. Keator
- Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Laura L. Murray
- Communication Sciences and Disorders, Western University, London, ON, Canada
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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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Cha S, Jeong B, Choi M, Kwon S, Lee SH, Paik NJ, Kim WS, Han CE. White matter tracts involved in subcortical unilateral spatial neglect in subacute stroke. Front Neurol 2022; 13:992107. [PMID: 36247754 PMCID: PMC9561922 DOI: 10.3389/fneur.2022.992107] [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: 07/12/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundUnilateral spatial neglect (USN) is common and associated with poor motor and cognitive outcomes as well as impaired quality of life following stroke. Traditionally, the neural substrates underlying USN have been thought to be cortical areas, such as the posterior parietal cortex. However, patients with stroke involving only subcortical structures may also present with USN. While only a few studies have reported on USN in subcortical stroke, the involvement of white matter tracts related to brain networks of visuospatial attention is one possible explanation for subcortical neglect. Therefore, this study aimed to investigate which specific white matter tracts are neural substrates for USN in patients with subcortical stroke.MethodsTwenty-two patients with subcortical stroke without cortical involvement who were admitted to the Department of Rehabilitation Medicine at Seoul National University Bundang Hospital were retrospectively enrolled. Nine subjects were subclassified into a “USN(+)” group, as they had at least two positive results on three tests (the Schenkenberg line bisection test, Albert's test, and house drawing test) and a score of 1 or higher on the Catherine Bergego scale. The remaining 13 subjects without abnormalities on those tests were subclassified into the “USN(–)” group. Stroke lesions on MRI were manually drawn using MRIcron software. Lesion overlapping and atlas-based analyses of MRI images were conducted. The correlation was analyzed between the overlapped lesion volumes with white matter tracts and the severity of USN (in the Albert test and the Catherine Bergego scale).ResultsLesions were more widespread in the USN(+) group than in the USN(–) group, although their locations in the right hemisphere were similar. The atlas-based analyses identified that the right cingulum in the cingulate cortex, the temporal projection of the superior longitudinal fasciculus, and the forceps minor significantly overlapped with the lesions in the USN(+) group than in the USN(–) group. The score of the Catherine Bergego scale correlated with the volume of the involved white matter tracts.ConclusionIn this study, white matter tracts associated with USN were identified in patients with subcortical stroke without any cortical involvement. Our study results, along with previous findings on subcortical USN, support that USN may result from damage to white matter pathways.
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Affiliation(s)
- Seungwoo Cha
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - ByeongChang Jeong
- Department of Electronics and Information Engineering, Korea University, Sejong, South Korea
- Interdisciplinary Graduate Program for Artificial Intelligence Smart Convergence Technology, Korea University, Sejong, South Korea
| | - Myungwon Choi
- Department of Electronics and Information Engineering, Korea University, Sejong, South Korea
| | - Sohyun Kwon
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Stephanie Hyeyoung Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
- Won-Seok Kim
| | - Cheol E. Han
- Department of Electronics and Information Engineering, Korea University, Sejong, South Korea
- Interdisciplinary Graduate Program for Artificial Intelligence Smart Convergence Technology, Korea University, Sejong, South Korea
- *Correspondence: Cheol E. Han
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Leveraging manifold learning techniques to explore white matter anomalies: An application of the TractLearn pipeline in epilepsy. Neuroimage Clin 2022; 36:103209. [PMID: 36162235 PMCID: PMC9668609 DOI: 10.1016/j.nicl.2022.103209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 12/14/2022]
Abstract
An accurate description of brain white matter anatomy in vivo remains a challenge. However, technical progress allows us to analyze structural variations in an increasingly sophisticated way. Current methods of processing diffusion MRI data now make it possible to correct some limiting biases. In addition, the development of statistical learning algorithms offers the opportunity to analyze the data from a new perspective. We applied newly developed tractography models to extract quantitative white matter parameters in a group of patients with chronic temporal lobe epilepsy. Furthermore, we implemented a statistical learning workflow optimized for the MRI diffusion data - the TractLearn pipeline - to model inter-individual variability and predict structural changes in patients. Finally, we interpreted white matter abnormalities in the context of several other parameters reflecting clinical status, as well as neuronal and cognitive functioning for these patients. Overall, we show the relevance of such a diffusion data processing pipeline for the evaluation of clinical populations. The "global to fine scale" funnel statistical approach proposed in this study also contributes to the understanding of neuroplasticity mechanisms involved in refractory epilepsy, thus enriching previous findings.
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Sperber C, Griffis J, Kasties V. Indirect structural disconnection-symptom mapping. Brain Struct Funct 2022; 227:3129-3144. [PMID: 36048282 DOI: 10.1007/s00429-022-02559-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 08/24/2022] [Indexed: 01/01/2023]
Abstract
In vivo tracking of white matter fibres catalysed a modern perspective on the pivotal role of brain connectome disruption in neuropsychological deficits. However, the examination of white matter integrity in neurological patients by diffusion-weighted magnetic resonance imaging bears conceptual limitations and is not widely applicable, as it requires imaging-compatible patients and resources beyond the capabilities of many researchers. The indirect estimation of structural disconnection offers an elegant and economical alternative. For this approach, a patient's structural lesion information and normative connectome data are combined to estimate different measures of lesion-induced structural disconnection. Using one of several toolboxes, this method is relatively easy to implement and is even available to scientists without expertise in fibre tracking analyses. Nevertheless, the anatomo-behavioural statistical mapping of structural brain disconnection requires analysis steps that are not covered by these toolboxes. In this paper, we first review the current state of indirect lesion disconnection estimation, the different existing measures, and the available software. Second, we aim to fill the remaining methodological gap in statistical disconnection-symptom mapping by providing an overview and guide to disconnection data and the statistical mapping of their relationship to behavioural measurements using either univariate or multivariate statistical modelling. To assist in the practical implementation of statistical analyses, we have included software tutorials and analysis scripts.
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Affiliation(s)
- Christoph Sperber
- University of Tubingen: Eberhard Karls Universitat Tubingen, Tubingen, Germany.
| | - Joseph Griffis
- University of Tubingen: Eberhard Karls Universitat Tubingen, Tubingen, Germany
| | - Vanessa Kasties
- Centre of Neurology, Hertie-Institute for Clinical Brain Research, University of Tubingen, Tubingen, Germany
- Child Development Center, University Childrens Hospital Zurich, University of Zurich, Zurich, Switzerland
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Cao L, Ye L, Xie H, Zhang Y, Song W. Neural substrates in patients with visual-spatial neglect recovering from right-hemispheric stroke. Front Neurosci 2022; 16:974653. [PMID: 36061609 PMCID: PMC9434016 DOI: 10.3389/fnins.2022.974653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Visual-spatial attention disorder after stroke seriously affects recovery and quality of life in stroke patients. Previous studies have shown that some patients recovery rapidly from visual-spatial neglect (VSN), but the brain networks underlying this recovery are not well understood. Using functional magnetic resonance imaging, we aimed to identify network differences between patients who rapidly recovered from VSN and those with persistent VSN. The study included 30 patients with VSN who suffered subacute stroke. Patients were examined 2–4 weeks after stroke onset and 4 weeks after the initial assessment. At the last evaluation, patients in the persistent VSN (n = 15) and rapid recovery (n = 15) groups underwent paper-and-pencil tests. We defined the bilateral frontal eye fields, bilateral intraparietal sulcus in the dorsal attention network, and right temporoparietal junction and ventral frontal cortex areas in the ventral attention network as regions of interest (ROI) and measured whole-brain ROI-based functional connectivity (FC) and amplitude of low-frequency fluctuations (ALFF) in subacute right-hemisphere stroke patients. VSN recovery was associated with changes in the activation of multiple bilateral attentional brain regions. Specifically, persistent VSN was associated with lower FC in the right superior frontal gyrus, right inferior temporal gyrus, right medial orbitofrontal cortex, left precuneus, right inferior parietal gyrus, right medial frontal gyrus, right rectus gyrus, left superior frontal gyrus, left middle cingulate gyrus, right superior temporal pole, right postcentral gyrus, and right posterior cingulate gyrus compared to that in those with rapid recovery, whereas ALFF in the left cerebellum were decreased in patients with persistent VSN. Our results demonstrate that the DAN rather than the VAN, plays a more important role in recovery from VSN, and that the cerebellum is involved in recovery. We believe that our results supplement those of previous studies on recovery from VSN.
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Affiliation(s)
- Lei Cao
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Linlin Ye
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, Beijing, China
- *Correspondence: Linlin Ye,
| | - Huanxin Xie
- Department of Orthopedics, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Yichen Zhang
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Weiqun Song
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, Beijing, China
- Weiqun Song,
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Right-side spatial neglect and white matter disconnection after left-hemisphere strokes. Brain Struct Funct 2022; 227:2991-3000. [PMID: 35925419 DOI: 10.1007/s00429-022-02541-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/17/2022] [Indexed: 11/02/2022]
Abstract
Spatial neglect usually concerns left-sided events after right-hemisphere damage. Its anatomical correlates are debated, with evidence suggesting an important role for fronto-parietal white matter disconnections in the right hemisphere. Here, we describe the less frequent occurrence of neglect for right-sided events, observed in three right-handed patients after a focal stroke in the left hemisphere. Patients were tested 1 month and 3 months after stroke. They performed a standardized paper-and-pencil neglect battery and underwent brain MRI with both structural and diffusion tensor (DT) sequences, in order to assess both grey matter and white matter tracts metrics. Lesions were manually reconstructed for each patient. Patients presented signs of mild right-sided neglect during visual search and line bisection. One patient also showed pathological performance in everyday life. Structural MRI demonstrated left parietal strokes in two patients, in the region extending from the postcentral gyrus to the temporo-parietal junction. One of these two patients also had had a previous occipital stroke. The remaining patient had a left frontal stroke, affecting the precentral, the postcentral gyri and the basal ganglia. DT MRI tractography showed disconnections in the fronto-parietal regions, concerning principally the superior longitudinal fasciculus (SLF). These results suggest an important role for left SLF disconnection in right-side neglect, which complements analogous evidence for right SLF disconnection in left-side neglect.
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Doricchi F, Lasaponara S, Pazzaglia M, Silvetti M. Left and right temporal-parietal junctions (TPJs) as "match/mismatch" hedonic machines: A unifying account of TPJ function. Phys Life Rev 2022; 42:56-92. [PMID: 35901654 DOI: 10.1016/j.plrev.2022.07.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
Experimental and theoretical studies have tried to gain insights into the involvement of the Temporal Parietal Junction (TPJ) in a broad range of cognitive functions like memory, attention, language, self-agency and theory of mind. Recent investigations have demonstrated the partition of the TPJ in discrete subsectors. Nonetheless, whether these subsectors play different roles or implement an overarching function remains debated. Here, based on a review of available evidence, we propose that the left TPJ codes both matches and mismatches between expected and actual sensory, motor, or cognitive events while the right TPJ codes mismatches. These operations help keeping track of statistical contingencies in personal, environmental, and conceptual space. We show that this hypothesis can account for the participation of the TPJ in disparate cognitive functions, including "humour", and explain: a) the higher incidence of spatial neglect in right brain damage; b) the different emotional reactions that follow left and right brain damage; c) the hemispheric lateralisation of optimistic bias mechanisms; d) the lateralisation of mechanisms that regulate routine and novelty behaviours. We propose that match and mismatch operations are aimed at approximating "free energy", in terms of the free energy principle of decision-making. By approximating "free energy", the match/mismatch TPJ system supports both information seeking to update one's own beliefs and the pleasure of being right in one's own' current choices. This renewed view of the TPJ has relevant clinical implications because the misfunctioning of TPJ-related "match" and "mismatch" circuits in unilateral brain damage can produce low-dimensional deficits of active-inference and predictive coding that can be associated with different neuropsychological disorders.
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Affiliation(s)
- Fabrizio Doricchi
- Dipartimento di Psicologia 39, Università degli Studi di Roma 'La Sapienza', Roma, Italy; Fondazione Santa Lucia IRCCS, Roma, Italy.
| | - Stefano Lasaponara
- Dipartimento di Psicologia 39, Università degli Studi di Roma 'La Sapienza', Roma, Italy; Fondazione Santa Lucia IRCCS, Roma, Italy
| | - Mariella Pazzaglia
- Dipartimento di Psicologia 39, Università degli Studi di Roma 'La Sapienza', Roma, Italy; Fondazione Santa Lucia IRCCS, Roma, Italy
| | - Massimo Silvetti
- Computational and Translational Neuroscience Lab (CTNLab), Institute of Cognitive Sciences and Technologies, National Research Council (CNR), Rome, Italy
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da Silva TR, de Carvalho Nunes HR, Martins LG, da Costa RDM, de Souza JT, Winckler FC, Sartor LCA, Modolo GP, Ferreira NC, da Silva Rodrigues JC, Kanda R, Fogarolli MO, Borges GF, Rizzatti GRS, Ribeiro PW, Favoretto DB, Aguiar L, Zanati Bazan SG, Betting LEG, de Oliveira Antunes LC, Mendes Pereira V, Santos TEG, Pontes-Neto O, Conforto AB, Bazan R, Luvizutto GJ. Brain stimulation can reduce unilateral spatial neglect after stroke: ELETRON trial. Ann Neurol 2022; 92:400-410. [PMID: 35688801 DOI: 10.1002/ana.26430] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/04/2022] [Accepted: 06/06/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Rehabilitation top-down techniques based on brain stimulation present variable outcomes in unilateral spatial neglect (USN) after stroke. This study aimed to examine the effects of physical therapy after anodal and cathodal direct current stimulation (A-tDCS and C-tDCS, respectively) to improve visuospatial and functional impairments in individuals with USN after stroke. METHODS This double-blinded, pilot randomized clinical trial enrolled patients with USN after ischemic stroke. Randomization was stratified according to Behavior Inattention Test Conventional (BIT-C) and Catherine Bergego Scale (CBS). Outpatient physical therapy was conducted for 7.5 weeks after 20 min of tDCS. The primary outcome was the USN degree evaluated by the BIT-C. Secondary outcomes were the difference in CBS score, stroke severity [National Institutes of Health Stroke Scale (NIHSS)], disability [modified Rankin Scale (mRS)], autonomy [Barthel Index (BI), functional independence measure (FIM)], and quality of life (EQ-5D). Outcomes were analyzed using ANCOVA model corrected by age, baseline NIHSS and baseline BIT-C. Pairwise posthoc comparisons were performed using Bonferroni correction. RESULTS In the primary outcomes, A-tDCS led to greater improvement in BIT-C after intervention (MD: 18.4; 95%CI: 3.9-32.8; p=0.008) compared to sham. However, no significant differences were observed between A-tDCS and C-tDCS (MD: 13.9; 95%CI: -0.3-28.1; p=0.057), or C-tDCS and sham (MD: 4.5; 95%CI: -9.7-18.8; p=0.99). There were no significant differences between groups in terms of secondary outcomes. CONCLUSIONS A-tDCS associated with physical therapy can decrease the severity of USN after stroke. However, these preliminary findings must be confirmed by collecting additional evidence in a larger phase III trial. REGISTRATION URL: https://ensaiosclinicos.gov.br/; Unique Identifier RBR-78jvzx This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Rafael Kanda
- Department of Neurology, Psychology and Psychiatry at Botucatu Medical School (UNESP)
| | | | | | | | | | - Diandra B Favoretto
- Department of Neurosciences and Behavioural Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Luan Aguiar
- Department of Neurosciences and Behavioural Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | | | | | - Taiza E Grespan Santos
- Department of Neurosciences and Behavioural Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Octávio Pontes-Neto
- Department of Neurosciences and Behavioural Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Adriana Bastos Conforto
- Hospital das Clínicas São Paulo University and Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Rodrigo Bazan
- Department of Neurology, Psychology and Psychiatry at Botucatu Medical School (UNESP)
| | - Gustavo José Luvizutto
- Department of Applied Physical Therapy, Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
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35
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Cavedoni S, Cipresso P, Mancuso V, Bruni F, Pedroli E. Virtual reality for the assessment and rehabilitation of neglect: where are we now? A 6-year review update. VIRTUAL REALITY 2022; 26:1663-1704. [PMID: 35669614 PMCID: PMC9148943 DOI: 10.1007/s10055-022-00648-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/24/2022] [Indexed: 06/13/2023]
Abstract
Unilateral spatial neglect (USN) is a frequent repercussion of a cerebrovascular accident, typically a stroke. USN patients fail to orient their attention to the contralesional side to detect auditory, visual, and somatosensory stimuli, as well as to collect and purposely use this information. Traditional methods for USN assessment and rehabilitation include paper-and-pencil procedures, which address cognitive functions as isolated from other aspects of patients' functioning within a real-life context. This might compromise the ecological validity of these procedures and limit their generalizability; moreover, USN evaluation and treatment currently lacks a gold standard. The field of technology has provided several promising tools that have been integrated within the clinical practice; over the years, a "first wave" has promoted computerized methods, which cannot provide an ecological and realistic environment and tasks. Thus, a "second wave" has fostered the implementation of virtual reality (VR) devices that, with different degrees of immersiveness, induce a sense of presence and allow patients to actively interact within the life-like setting. The present paper provides an updated, comprehensive picture of VR devices in the assessment and rehabilitation of USN, building on the review of Pedroli et al. (2015). The present paper analyzes the methodological and technological aspects of the studies selected, considering the issue of usability and ecological validity of virtual environments and tasks. Despite the technological advancement, the studies in this field lack methodological rigor as well as a proper evaluation of VR usability and should improve the ecological validity of VR-based assessment and rehabilitation of USN.
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Affiliation(s)
- S. Cavedoni
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - P. Cipresso
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, TO Italy
| | - V. Mancuso
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - F. Bruni
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - E. Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, eCampus University, Novedrate, Italy
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36
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Tomaiuolo F, Raffa G, Campana S, Garufi G, Lasaponara S, Voci L, Cardali SM, Germanò A, Doricchi F, Petrides M. Splenial Callosal Disconnection in Right Hemianopic Patients Induces Right Visual-Spatial Neglect. Brain Sci 2022; 12:brainsci12050640. [PMID: 35625026 PMCID: PMC9139425 DOI: 10.3390/brainsci12050640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/22/2022] [Accepted: 05/04/2022] [Indexed: 02/04/2023] Open
Abstract
Posterior cerebral artery (PCA) territory infarction involving occipital cortical damage can give rise to contralateral homonymous hemianopia. Here, we report two rare cases of patients with lesions in the left hemisphere PCA territory who developed right visuo-spatial neglect. One patient suffered right hemianopia and right visuo-spatial neglect after a stroke that damaged the left primary visual cortex and the callosal splenial fibers. The other unique case is of a patient who had a brain tumor in the posterior cerebral region in the left hemisphere and initially exhibited only right hemianopia that developed into right visuo-spatial neglect after tumor resection that included the splenial fibers. These cases indicate that, as in cases with damage in the right PCA territory, lesions in the left PCA yield visuo-spatial neglect when the damage produces contralateral hemianopia and concomitant disconnection of the splenium of the corpus callosum, which interferes with the arrival of visual inputs from the intact right to the lesioned left hemisphere. These results also emphasize the necessity of sparing the splenial fibers in surgical interventions in patients who exhibit hemianopia.
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Affiliation(s)
- Francesco Tomaiuolo
- Department of Clinical and Experimental Medicine, University of Messina, Piazza Pugliatti, 1, 98122 Messina, Italy
- Correspondence: (F.T.); (A.G.)
| | - Giovanni Raffa
- Division of Neurosurgery, Department BIOMORF, University of Messina, Piazza Pugliatti, 1, 98122 Messina, Italy; (G.R.); (G.G.); (S.M.C.)
| | - Serena Campana
- Neurorehabilitation Unit, Auxilium Vitae Volterra, Via Borgo San Lazzero 5, 56048 Volterra, Italy; (S.C.); (L.V.)
| | - Giada Garufi
- Division of Neurosurgery, Department BIOMORF, University of Messina, Piazza Pugliatti, 1, 98122 Messina, Italy; (G.R.); (G.G.); (S.M.C.)
| | - Stefano Lasaponara
- Department of Psychology, La Sapienza University, Piazzale Aldo Moro 5, 00185 Rome, Italy; (S.L.); (F.D.)
- Laboratorio di Neuropsicologia dell’Attenzione, Fondazione Santa Lucia IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
- Dipartimento di Scienze Umane, Libera Università Maria Santissima Assunta LUMSA, Via della Traspontina, 21, 00193 Rome, Italy
| | - Loredana Voci
- Neurorehabilitation Unit, Auxilium Vitae Volterra, Via Borgo San Lazzero 5, 56048 Volterra, Italy; (S.C.); (L.V.)
| | - Salvatore M. Cardali
- Division of Neurosurgery, Department BIOMORF, University of Messina, Piazza Pugliatti, 1, 98122 Messina, Italy; (G.R.); (G.G.); (S.M.C.)
| | - Antonino Germanò
- Division of Neurosurgery, Department BIOMORF, University of Messina, Piazza Pugliatti, 1, 98122 Messina, Italy; (G.R.); (G.G.); (S.M.C.)
- Correspondence: (F.T.); (A.G.)
| | - Fabrizio Doricchi
- Department of Psychology, La Sapienza University, Piazzale Aldo Moro 5, 00185 Rome, Italy; (S.L.); (F.D.)
- Laboratorio di Neuropsicologia dell’Attenzione, Fondazione Santa Lucia IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Michael Petrides
- Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, QC H3A 2B4, Canada;
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Imura T, Mitsutake T, Hori T, Tanaka R. Predicting the prognosis of unilateral spatial neglect using magnetic resonance imaging in patients with stroke: A systematic review. Brain Res 2022; 1789:147954. [DOI: 10.1016/j.brainres.2022.147954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/21/2022] [Accepted: 05/24/2022] [Indexed: 11/24/2022]
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38
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Swayne OB, Gorgoraptis N, Leff A, Ajina S. Exploring the use of dopaminergic medication to treat hemispatial inattention during in-patient post-stroke neurorehabilitation. J Neuropsychol 2022; 16:518-536. [PMID: 35384324 DOI: 10.1111/jnp.12276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/08/2022] [Accepted: 03/16/2022] [Indexed: 12/20/2022]
Abstract
Hemispatial inattention (HSI), a lateralised impairment of spatial processing, is a common consequence of stroke. It is a poor prognostic indicator for functional recovery and interferes with the progress during in-patient neurorehabilitation. Dopaminergic medication has shown promise in improving HSI in the chronic post-stroke period but is untested in more acute settings, e.g. during in-patient neurorehabilitation. We audited the use of dopaminergic medication in ten sequential patients with post-stroke HSI, on an open-label exploratory basis. Patients' response to medication was assessed individually, using a three-week Off-On-Off protocol. We employed a mixture of bedside and functional measures, and made a multidisciplinary judgement of efficacy in individual patients. In six out of 10 patients, there was a convincing improvement of HSI while on medication, which reversed when it was paused. There was a mean 57% relative increase in target detection in the star cancellation test on the most affected side (on vs. off medication). In the six responders, medication was therefore continued throughout their admission without adverse effects. The star cancellation test was sensitive to HSI in most patients but in two cases failed to detect changes that were picked up by a functional assessment (Kessler Functional Neglect Assessment Protocol). We found this multidisciplinary approach to be feasible in an in-patient neurorehabilitation setting. We suggest further research to explore the efficacy of dopaminergic medication in improving neurorehabilitation outcomes for patients with post-stroke HSI. We suggest that more detailed N-of-1 assessments of treatment response, with internal blinding, may be a productive approach.
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Affiliation(s)
- Orlando B Swayne
- National Hospital for Neurology & Neurosurgery, London, UK.,Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, UK
| | - Nikos Gorgoraptis
- Department of Neurology, Barts Health NHS Trust, London, UK.,Regional Neurorehabilitation Unit, Homerton University Hospital NHS Foundation Trust, London, UK.,Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK
| | - Alex Leff
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, UK
| | - Sara Ajina
- National Hospital for Neurology & Neurosurgery, London, UK.,Wellcome Centre for Integrative Neuroimaging, FMRIB, Oxford, UK
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39
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Errante A, Rossi Sebastiano A, Ziccarelli S, Bruno V, Rozzi S, Pia L, Fogassi L, Garbarini F. Structural connectivity associated with the sense of body ownership: a diffusion tensor imaging and disconnection study in patients with bodily awareness disorder. Brain Commun 2022; 4:fcac032. [PMID: 35233523 PMCID: PMC8882004 DOI: 10.1093/braincomms/fcac032] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/25/2021] [Accepted: 02/09/2022] [Indexed: 12/02/2022] Open
Abstract
The brain mechanisms underlying the emergence of a normal sense of body ownership can be investigated starting from pathological conditions in which body awareness is selectively impaired. Here, we focused on pathological embodiment, a body ownership disturbance observed in brain-damaged patients who misidentify other people’s limbs as their own. We investigated whether such body ownership disturbance can be classified as a disconnection syndrome, using three different approaches based on diffusion tensor imaging: (i) reconstruction of disconnectome maps in a large sample (N = 70) of stroke patients with and without pathological embodiment; (ii) probabilistic tractography, performed on the age-matched healthy controls (N = 16), to trace cortical connections potentially interrupted in patients with pathological embodiment and spared in patients without this pathological condition; (iii) probabilistic ‘in vivo’ tractography on two patients without and one patient with pathological embodiment. The converging results revealed the arcuate fasciculus and the third branch of the superior longitudinal fasciculus as mainly involved fibre tracts in patients showing pathological embodiment, suggesting that this condition could be related to the disconnection between frontal, parietal and temporal areas. This evidence raises the possibility of a ventral self-body recognition route including regions where visual (computed in occipito-temporal areas) and sensorimotor (stored in premotor and parietal areas) body representations are integrated, giving rise to a normal sense of body ownership.
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Affiliation(s)
- Antonino Errante
- Department of Medicine and Surgery, University of Parma, Parma, 43125, Italy
| | | | - Settimio Ziccarelli
- Department of Medicine and Surgery, University of Parma, Parma, 43125, Italy
| | - Valentina Bruno
- MANIBUS Lab, Psychology Department, University of Turin, Turin 10123, Italy
| | - Stefano Rozzi
- Department of Medicine and Surgery, University of Parma, Parma, 43125, Italy
| | - Lorenzo Pia
- SAMBA Research Group, Psychology Department, University of Turin, Turin 10123, Italy
- Neuroscience Institute of Turin (NIT), Turin 10123, Italy
| | - Leonardo Fogassi
- Department of Medicine and Surgery, University of Parma, Parma, 43125, Italy
| | - Francesca Garbarini
- MANIBUS Lab, Psychology Department, University of Turin, Turin 10123, Italy
- Neuroscience Institute of Turin (NIT), Turin 10123, Italy
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40
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Landers MJ, Baene WD, Rutten GJ, Mandonnet E. The third branch of the superior longitudinal system. J Neurosurg Sci 2022; 65:548-559. [PMID: 35128918 DOI: 10.23736/s0390-5616.21.05423-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
One of the major associative fiber pathways in the brain is the superior longitudinal system. This review discusses the current knowledge gained from studies on the third branch of the superior longitudinal system (SLS) regarding its anatomy, functional role in healthy individuals, results from lesion-symptom mapping studies and intraoperative electrostimulation studies. The results of these studies clearly indicate that the third branch of the SLS is a distinct pathway, as seen both from a functional and anatomical perspective. The third branch of the SLS should be distinguished from the long segment of the arcuate fasciculus, that courses along its trajectory but seems implicated in different functions. Moreover, these studies also provide substantial evidence that the right and left third branch of the SLS have different functional roles. Finally, a hypothesis for an integrated anatomo-functional model is proposed, that describes three subcomponents of the third branch of the superior longitudinal system.
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Affiliation(s)
- Maud J Landers
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands.,Department of Cognitive Neuropsychology, University of Tilburg, Tilburg, the Netherlands
| | - Wouter de Baene
- Department of Cognitive Neuropsychology, University of Tilburg, Tilburg, the Netherlands
| | - Geert J Rutten
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands.,Department of Cognitive Neuropsychology, University of Tilburg, Tilburg, the Netherlands
| | - Emmanuel Mandonnet
- University of Paris, Paris, France - .,Frontlab, Institut du Cerveau (ICM), CNRS UMR 7225, INSERM U1127, Paris, France.,Service of Neurosurgery, Lariboisière Hospital, Paris, France
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41
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Can music restore brain connectivity in post-stroke cognitive deficits? Med Hypotheses 2022. [DOI: 10.1016/j.mehy.2022.110761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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42
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Rosenzopf H, Wiesen D, Basilakos A, Yourganov G, Bonilha L, Rorden C, Fridriksson J, Karnath HO, Sperber C. Mapping the human praxis network: an investigation of white matter disconnection in limb apraxia of gesture production. Brain Commun 2022; 4:fcac004. [PMID: 35169709 PMCID: PMC8833454 DOI: 10.1093/braincomms/fcac004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/19/2021] [Accepted: 01/07/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Left hemispheric cerebral stroke can cause apraxia, a motor-cognitive disorder characterised by deficits of higher-order motor skills such as the failure to accurately produce meaningful gestures. This disorder provides unique insights into the anatomical and cognitive architecture of the human praxis system. The present study aimed to map the structural brain network that is damaged in apraxia. We assessed the ability to perform meaningful gestures with the hand in 101 patients with chronic left hemisphere stroke. Structural white matter fibre damage was directly assessed by diffusion tensor imaging and fractional anisotropy mapping. We used multivariate topographical inference on tract-based fractional anisotropy topographies to identify white matter disconnection associated with apraxia. We found relevant pathological white matter alterations in a densely connected fronto-temporo-parietal network of short and long association fibres. Hence, the findings suggest that heterogeneous topographical results in previous lesion mapping studies might not only result from differences in study design, but also from the general methodological limitations of univariate topographical mapping in uncovering the structural praxis network. A striking role of middle and superior temporal lobe disconnection, including temporo-temporal short association fibres, was found, suggesting strong involvement of the temporal lobe in the praxis network. Further, the results stressed the importance of subcortical disconnections for the emergence of apractic symptoms. Our study provides a fine-grain view into the structural connectivity of the human praxis network and suggests a potential value of disconnection measures in the clinical prediction of behavioural post-stroke outcome.
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Affiliation(s)
- Hannah Rosenzopf
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Daniel Wiesen
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Alexandra Basilakos
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Grigori Yourganov
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Christopher Rorden
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - 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, USA
| | - Christoph Sperber
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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43
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Abstract
What are mental images needed for? A variety of everyday situations calls for us to plan ahead; one of the clever ways our mind prepares and strategizes our next move is through mental simulation. A powerful tool in running these simulations is visual mental imagery, which can be conceived as a way to activate and maintain an internal representation of the to-be-imagined object, giving rise to predictions. Therefore, under normal conditions imagination is primarily an endogenous process, and only more rarely can mental images be activated exogenously, for example, by means of intracerebral stimulation. A large debate is still ongoing regarding the neural substrates supporting mental imagery, with the neuropsychological and neuroimaging literature agreeing in some cases, but not others. This chapter reviews the neuroscientific literature on mental imagery, and attempts to reappraise the neuropsychological and neuroimaging evidence by drawing a model of mental imagery informed by both structural and functional brain data. Overall, the role of regions in the ventral temporal cortex, especially of the left hemisphere, stands out unequivocally as a key substrate in mental imagery.
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Affiliation(s)
- Alfredo Spagna
- Department of Psychology, Columbia University, New York City, NY, United States.
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44
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Kaufmann B, Cazzoli D, Bartolomeo P, Frey J, Pflugshaupt T, Knobel S, Nef T, Müri R, Nyffeler T. Auditory spatial cueing reduces neglect after right-hemispheric stroke: a proof of concept study. Cortex 2022; 148:152-167. [DOI: 10.1016/j.cortex.2021.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/20/2021] [Accepted: 12/09/2021] [Indexed: 11/26/2022]
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45
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Williams LJ, Kernot J, Hillier SL, Loetscher T. Spatial Neglect Subtypes, Definitions and Assessment Tools: A Scoping Review. Front Neurol 2021; 12:742365. [PMID: 34899565 PMCID: PMC8653914 DOI: 10.3389/fneur.2021.742365] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/14/2021] [Indexed: 12/03/2022] Open
Abstract
Objective: The objective of this scoping review was to capture the reported definitions for the subtypes of neglect post stroke and map the range of assessment tools employed for each neglect subtype. Methods: EMBASE, Emcare, Medline, and psychINFO were searched from database inception. Searching included all allied terms and mesh headings for stroke, spatial neglect, measurement, screening tools, psychometric properties. Two reviewers independently screened studies for inclusion. Primary studies with documented protocols of a spatial neglect tool for adults post stroke, with some aspect of validity or reliability were included. Two reviewers independently reviewed the documented protocols of each tool to determine the underlying subtypes and disagreements were resolved through discussion. Results: There were 371 articles included with 292 tools used for the screening or diagnosis of neglect. The majority of studies (67%) included a tool that did not specify the neglect subtype being assessed, therefore an analysis of the underlying subtypes for each tool is presented. Conclusions: There is no consistency with the terms used to refer to the syndrome of spatial neglect with over 200 different terms used within the included studies to refer to the syndrome as a whole or one of its subtypes. It is essential to unify the terminology and definition for each neglect subtype. There are hundreds of neglect tools available, however many are not able to differentiate presenting subtypes. It is important for clinicians and researchers to critically evaluate the neglect tools being used for the screening and diagnosis of neglect.
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Affiliation(s)
- Lindy J Williams
- Cognitive Aging and Impairment Neurosciences Lab, University of South Australia, Adelaide, SA, Australia.,Innovation IMPlementation and Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, SA, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Jocelyn Kernot
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Susan L Hillier
- Innovation IMPlementation and Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, SA, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Tobias Loetscher
- Cognitive Aging and Impairment Neurosciences Lab, University of South Australia, Adelaide, SA, Australia.,Justice and Society, University of South Australia, Adelaide, SA, Australia
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46
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Houben M, Chettouf S, Van Der Werf YD, Stins J. Theta-burst transcranial magnetic stimulation for the treatment of unilateral neglect in stroke patients: A systematic review and best evidence synthesis. Restor Neurol Neurosci 2021; 39:447-465. [PMID: 34864705 PMCID: PMC8764600 DOI: 10.3233/rnn-211228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Unilateral neglect (UN) is a common and disabling disorder after stroke. UN is a strong and negative predictor of functional rehabilitative outcome. Non-invasive brain stimulation, such as theta-burst transcranial magnetic stimulation (TBS), is a promising rehabilitation technique for treating stroke-induced UN. OBJECTIVE To systematically review the available literature, researching whether TBS of the contra-lesional hemisphere is more effective than standard rehabilitation in improving symptoms of UN in patients with right hemisphere stroke. REVIEW METHODS A systematic review was conducted to retrieve randomized controlled trials (RCTs) that were relevant to the objective of this review. PubMed, Ovid and Cochrane Library electronic databases were comprehensively searched from inception up to February 2021. Of the included studies, methodological quality was assessed using the PEDro scale, whereafter a best evidence synthesis (BES) was conducted to summarize the results. RESULTS Nine RCTs investigating the effects of TBS on stroke-induced UN symptoms were included in this review. Seven studies assessing continuous TBS (cTBS) found significantly greater amelioration of UN symptoms in the TBS intervention group when compared to the control group; one study assessing cTBS found no such significant difference. One study assessing intermittent TBS (iTBS) found significant between-group differences in favor of the intervention. The BES yielded strong evidence in favor of cTBS, and limited evidence in favor of iTBS. CONCLUSIONS The included studies in the present review allow the conclusion that TBS can have favorable effects on UN recovery in stroke patients. Its clinical use is recommended in conjunction with cognitive rehabilitation and occupational or physical rehabilitation as needed. However, many aspects for optimal usage of TBS therapy in clinical settings, such as exact TBS protocols, number of sessions, and treatment duration, are not clear.
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Affiliation(s)
- Milan Houben
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7 Amsterdam, The Netherlands
| | - Sabrina Chettouf
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7 Amsterdam, The Netherlands
| | - Ysbrand D Van Der Werf
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117 Amsterdam, The Netherlands
| | - John Stins
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7 Amsterdam, The Netherlands
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47
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Chen Y, Jiang Y, Kong X, Zhao C, Zhong S, Yang L, Feng T, Peng S, Bi Y, Corbetta M, Gong G. Common and unique structural plasticity after left and right hemisphere stroke. J Cereb Blood Flow Metab 2021; 41:3350-3364. [PMID: 34415210 PMCID: PMC8669287 DOI: 10.1177/0271678x211036606] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Strokes to the left and right hemisphere lead to distinctive behavioral profiles. Are left and right hemisphere strokes (LHS and RHS) associated with distinct or common poststroke neuroplasticity patterns? Understanding this issue would reveal hemispheric neuroplasticity mechanisms in response to brain damage. To this end, we investigated poststroke structural changes (2 weeks to 3 months post-onset) using longitudinal MRI data from 69 LHS and 55 RHS patients and 31 demographic-matched healthy control participants. Both LHS and RHS groups showed statistically common plasticity independent of the lesioned hemisphere, including 1) gray matter (GM) expansion in the ipsilesional and contralesional precuneus, and contralesional superior frontal gyrus; 2) GM shrinkage in the ipsilesional medial orbital frontal gyrus and middle cingulate cortex. On the other hand, only RHS patients had significant GM expansion in the ipsilesional medial superior and orbital frontal cortex. Importantly, these common and unique GM changes post-stroke largely overlapped with highly-connected cortical hub regions in healthy individuals. Moreover, they correlated with behavioral recovery, indicating that post-stroke GM volumetric changes in cortical hubs reflect compensatory rather than maladaptive mechanisms. These results highlight the importance of structural neuroplasticity in hub regions of the cortex, along with the hemispheric specificity, for stroke recovery.
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Affiliation(s)
- Yijun Chen
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Yaya Jiang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xiangyu Kong
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Chenxi Zhao
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Suyu Zhong
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Liyuan Yang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Tao Feng
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Shaoling Peng
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Yanchao Bi
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
| | - Maurizio Corbetta
- Department of Neuroscience, Neurology Clinic, University of Padua, Padua, Italy.,Padova Neuroscience Center, University of Padua, Padua, Italy.,Venetian Institute of Molecular Medicine, Padova, Italy.,Department of Neurology, Radiology, and Neuroscience, Washington University in St. Louis, St. Louis, USA
| | - Gaolang Gong
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
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48
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Toba MN, Barbeau EJ. Plasticity and cerebral reorganization: An update. Rev Neurol (Paris) 2021; 177:1090-1092. [PMID: 34772473 DOI: 10.1016/j.neurol.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/10/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022]
Affiliation(s)
- M N Toba
- CHU Amiens Picardie - Site Sud, Centre Universitaire de Recherche en Sant., avenue Rene Laennec, 80054 Amiens cedex 1, France.
| | - E J Barbeau
- Centre de Recherche Cerveau et Cognition (CerCo), UMR5549, CNRS - Université de Toulouse, Toulouse, France
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49
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Bartolomeo P. From competition to cooperation: Visual neglect across the hemispheres. Rev Neurol (Paris) 2021; 177:1104-1111. [PMID: 34561121 DOI: 10.1016/j.neurol.2021.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 07/23/2021] [Indexed: 12/13/2022]
Abstract
Visuospatial neglect is a frequent and disabling consequence of injuries to the right hemisphere. Patients with neglect show signs of impaired attention for left-sided events, which depends on dysfunction of fronto-parietal networks. After unilateral injury, such as stroke, these networks and their contralateral homologs can reorganize following multiple potential trajectories, which can be either adaptive or maladaptive. This article presents possible factors influencing the profile of evolution of neglect towards recovery or chronicity, and highlights potential mechanisms that may constrain these processes in time and space. The integrity of white matter pathways within and between the hemisphere appears to pose crucial connectivity constraints for compensatory brain plasticity from remote brain regions. Specifically, the availability of a sufficient degree of inter-hemispheric connectivity might be critical to shift the role of the undamaged left hemisphere in spatial neglect, from exerting maladaptive effects, to promoting compensatory activity.
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Affiliation(s)
- P Bartolomeo
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, hôpital de la Pitié-Salpêtrière, 75013 Paris, France.
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50
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Gajardo-Vidal A, Lorca-Puls DL, Team P, Warner H, Pshdary B, Crinion JT, Leff AP, Hope TMH, Geva S, Seghier ML, Green DW, Bowman H, Price CJ. Damage to Broca's area does not contribute to long-term speech production outcome after stroke. Brain 2021; 144:817-832. [PMID: 33517378 PMCID: PMC8041045 DOI: 10.1093/brain/awaa460] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/12/2020] [Accepted: 10/22/2020] [Indexed: 02/03/2023] Open
Abstract
Broca's area in the posterior half of the left inferior frontal gyrus has long been thought to be critical for speech production. The current view is that long-term speech production outcome in patients with Broca's area damage is best explained by the combination of damage to Broca's area and neighbouring regions including the underlying white matter, which was also damaged in Paul Broca's two historic cases. Here, we dissociate the effect of damage to Broca's area from the effect of damage to surrounding areas by studying long-term speech production outcome in 134 stroke survivors with relatively circumscribed left frontal lobe lesions that spared posterior speech production areas in lateral inferior parietal and superior temporal association cortices. Collectively, these patients had varying degrees of damage to one or more of nine atlas-based grey or white matter regions: Brodmann areas 44 and 45 (together known as Broca's area), ventral premotor cortex, primary motor cortex, insula, putamen, the anterior segment of the arcuate fasciculus, uncinate fasciculus and frontal aslant tract. Spoken picture description scores from the Comprehensive Aphasia Test were used as the outcome measure. Multiple regression analyses allowed us to tease apart the contribution of other variables influencing speech production abilities such as total lesion volume and time post-stroke. We found that, in our sample of patients with left frontal damage, long-term speech production impairments (lasting beyond 3 months post-stroke) were solely predicted by the degree of damage to white matter, directly above the insula, in the vicinity of the anterior part of the arcuate fasciculus, with no contribution from the degree of damage to Broca's area (as confirmed with Bayesian statistics). The effect of white matter damage cannot be explained by a disconnection of Broca's area, because speech production scores were worse after damage to the anterior arcuate fasciculus with relative sparing of Broca's area than after damage to Broca's area with relative sparing of the anterior arcuate fasciculus. Our findings provide evidence for three novel conclusions: (i) Broca's area damage does not contribute to long-term speech production outcome after left frontal lobe strokes; (ii) persistent speech production impairments after damage to the anterior arcuate fasciculus cannot be explained by a disconnection of Broca's area; and (iii) the prior association between persistent speech production impairments and Broca's area damage can be explained by co-occurring white matter damage, above the insula, in the vicinity of the anterior part of the arcuate fasciculus.
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Affiliation(s)
- Andrea Gajardo-Vidal
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK.,Faculty of Health Sciences, Universidad del Desarrollo, Concepcion, Chile
| | - Diego L Lorca-Puls
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK.,Department of Speech, Language and Hearing Sciences, Faculty of Medicine, Universidad de Concepcion, Concepcion, Chile
| | - Ploras Team
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Holly Warner
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Bawan Pshdary
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Jennifer T Crinion
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Alexander P Leff
- Institute of Cognitive Neuroscience, University College London, London, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - Thomas M H Hope
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Sharon Geva
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Mohamed L Seghier
- Cognitive Neuroimaging Unit, Emirates College for Advanced Education, Abu Dhabi, UAE.,Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, UAE
| | - David W Green
- Department of Experimental Psychology, University College London, London, UK
| | - Howard Bowman
- Centre for Cognitive Neuroscience and Cognitive Systems and the School of Computing, University of Kent, Canterbury, UK.,School of Psychology, University of Birmingham, Birmingham, UK
| | - Cathy J Price
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
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