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Gallucci L, Sperber C, Guggisberg AG, Kaller CP, Heldner MR, Monsch AU, Hakim A, Silimon N, Fischer U, Arnold M, Umarova RM. Post-stroke cognitive impairment remains highly prevalent and disabling despite state-of-the-art stroke treatment. Int J Stroke 2024:17474930241238637. [PMID: 38425239 DOI: 10.1177/17474930241238637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND State-of-the-art stroke treatment significantly reduces lesion size and stroke severity, but it remains unclear whether these therapeutic advances have diminished the burden of post-stroke cognitive impairment (PSCI). AIMS In a cohort of patients receiving modern state-of-the-art stroke care including endovascular therapy, we assessed the frequency of PSCI and the pattern of domain-specific cognitive deficits, identified risk factors for PSCI, and determined the impact of acute PSCI on stroke outcome. METHODS In this prospective monocentric cohort study, we examined patients with first-ever anterior circulation ischemic stroke without pre-stroke cognitive decline, using a comprehensive neuropsychological assessment ⩽10 days after symptom onset. Normative data were stratified by demographic variables. We defined PSCI as at least moderate (<1.5 standard deviation) deficits in ⩾2 cognitive domains. Multivariable regression analysis was applied to define risk factors for PSCI. RESULTS We analyzed 329 non-aphasic patients admitted from December 2020 to July 2023 (67.2 ± 14.4 years old, 41.3% female, 13.1 ± 2.7 years of education). Although most patients had mild stroke (median National Institutes of Health Stroke Scale (NIHSS) 24 h = 1.00 (0.00; 3.00); 87.5% with NIHSS ⩽ 5), 69.3% of them presented with PSCI 2.7 ± 2.0 days post-stroke. The most severely and often affected cognitive domains were verbal learning, episodic memory, executive functions, selective attention, and constructive abilities (39.1%-51.2% of patients), whereas spatial neglect was less frequent (18.5%). The risk of PSCI was reduced with more years of education (odds ratio (OR) = 0.47, 95% confidence interval (CI) = 0.23-0.99) and right hemisphere lesions (OR = 0.47, 95% CI = 0.26-0.84), and increased with stroke severity (NIHSS 24 h, OR = 4.19, 95% CI = 2.72-6.45), presence of hyperlipidemia (OR = 1.93, 95% CI = 1.01-3.68), but was not influenced by age. After adjusting for stroke severity and depressive symptoms, acute PSCI was associated with poor functional outcome (modified Rankin Scale > 2, F = 13.695, p < 0.001) and worse global cognition (Montreal Cognitive Assessment (MoCA) score, F = 20.069, p < 0.001) at 3 months post-stroke. CONCLUSION Despite modern stroke therapy and many strokes having mild severity, PSCI in the acute stroke phase remains frequent and associated with worse outcome. The most prevalent were learning and memory deficits. Cognitive reserve operationalized as years of education independently protects post-stroke cognition.
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Affiliation(s)
- Laura Gallucci
- Department of Neurology, University Hospital, Inselspital, University of Bern, Bern, Switzerland
- Graduate School of Health Sciences, University of Bern, Bern, Switzerland
| | - Christoph Sperber
- Department of Neurology, University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Adrian G Guggisberg
- Department of Neurology, University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Christoph P Kaller
- Department of Neuroradiology, University Medical Center Freiburg, Freiburg, Germany
| | - Mirjam R Heldner
- Department of Neurology, University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | | | - Arsany Hakim
- University Institute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Norbert Silimon
- Department of Neurology, University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Urs Fischer
- Department of Neurology, University Hospital, Inselspital, University of Bern, Bern, Switzerland
- Department of Neurology, University Hospital and University of Basel, Basel, Switzerland
| | - Marcel Arnold
- Department of Neurology, University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Roza M Umarova
- Department of Neurology, University Hospital, Inselspital, University of Bern, Bern, Switzerland
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McDowell N, Butler P. Validation of the Austin Assessment: A screening tool for cerebral visual impairment related visual issues. PLoS One 2023; 18:e0293904. [PMID: 37917596 PMCID: PMC10621811 DOI: 10.1371/journal.pone.0293904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/21/2023] [Indexed: 11/04/2023] Open
Abstract
Cerebral visual impairment is the most common cause of vision impairment affecting children in the economically developed world with a prevalence rate of approximately 3.4%. Currently there are limited options for screening for cerebral visual impairment, resulting in many children going undiagnosed, especially those that have normal visual acuity. The aim of this research was to validate an iPad App called the Austin Assessment, which was developed as a potential screening tool for cerebral visual impairment related visual issues. The research involved three separate phases: (1) creating a database of normative ranges for children aged 5-18 across the different variables of the Austin Assessment, (2) using the Austin Assessment to screen children aged 5-13 to assess the effectiveness of the Austin Assessment as a screening tool for CVI related visual issues, and (3) conducting specific validation research assessing children using the Austin Assessment and an already validated visual search tool. Each phase used different quantitative research methodologies to help show the effectiveness of the Austin Assessment as a screening tool for cerebral visual impairment related visual issues. From phase one of the research, thresholds were established for three variables of the Austin Assessment for the age groupings of 5-8, 9-12 and 13-18. If a child meets one of these thresholds this indicates further assessment is required to determine if they do in fact have cerebral visual impairment related visual issues. Phase two identified 17 children out of 270 who had clinical findings indicating visual issues; potentially indicative of CVI; investigation into the nature of these visual issues is ongoing. Phase three found that the Austin Assessment has moderate diagnostic value for each age group, with good sensitivity and specificity, making it effective at distinguishing those children who have visual issues from those who have typical vision. Further investigation is needed to confirm this initial validation.
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Affiliation(s)
- Nicola McDowell
- Institute of Education, Massey University, Auckland, New Zealand
| | - Philippa Butler
- Institute of Education, Massey University, Auckland, New Zealand
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Cantarella G, Vianello G, Vezzadini G, Frassinetti F, Ciaramelli E, Candini M. Time bisection and reproduction: Evidence for a slowdown of the internal clock in right brain damaged patients. Cortex 2023; 167:303-317. [PMID: 37595392 DOI: 10.1016/j.cortex.2023.05.024] [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: 10/06/2022] [Revised: 03/31/2023] [Accepted: 05/24/2023] [Indexed: 08/20/2023]
Abstract
Previous studies show that the right hemisphere is involved in time processing, and that damage to the right hemisphere is associated with a tendency to perceive time intervals as shorter than they are, and to reproduce time intervals as longer than they are. Whether time processing deficits following right hemisphere damage are related and what is their neurocognitive basis is unclear. In this study, right brain damaged (RBD) patients, left brain damaged (LBD) patients, and healthy controls underwent a time bisection task and a time reproduction task involving time intervals varying between each other by milliseconds (short durations) or seconds (long durations). The results show that in the time bisection task RBD patients underestimated time intervals compared to LBD patients and healthy controls, while they reproduced time intervals as longer than they are. Time underestimation and over-reproduction in RBD patients applied to short but not long time intervals, and were correlated. Voxel-based lesion-symptom mapping (VLSM) showed that time underestimation was associated with lesions to a right cortico-subcortical network involving the insula and inferior frontal gyrus. A small portion of this network was also associated with time over-reproduction. Our findings are consistent with a slowdown of an 'internal clock' timing mechanism following right brain damage, which likely underlies both the underestimation and the over-reproduction of time intervals, and their (overlapping) neural bases.
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Affiliation(s)
- Giovanni Cantarella
- Department of Psychology 'Renzo Canestrari', University of Bologna, Bologna, Italy; Center for Studies and Research of Cognitive Neuroscience, University of Bologna, Cesena, Italy
| | - Greta Vianello
- Istituti Clinici Scientifici Maugeri IRCCS, Castel Goffredo, Italy
| | | | - Francesca Frassinetti
- Department of Psychology 'Renzo Canestrari', University of Bologna, Bologna, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Castel Goffredo, Italy
| | - Elisa Ciaramelli
- Department of Psychology 'Renzo Canestrari', University of Bologna, Bologna, Italy; Center for Studies and Research of Cognitive Neuroscience, University of Bologna, Cesena, Italy.
| | - Michela Candini
- Department of Psychology 'Renzo Canestrari', University of Bologna, Bologna, Italy.
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Salvalaggio S, Turolla A, Andò M, Barresi R, Burgio F, Busan P, Cortese AM, D’Imperio D, Danesin L, Ferrazzi G, Maistrello L, Mascotto E, Parrotta I, Pezzetta R, Rigon E, Vedovato A, Zago S, Zorzi M, Arcara G, Mantini D, Filippini N. Prediction of rehabilitation induced motor recovery after stroke using a multi-dimensional and multi-modal approach. Front Aging Neurosci 2023; 15:1205063. [PMID: 37469951 PMCID: PMC10352609 DOI: 10.3389/fnagi.2023.1205063] [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: 04/13/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023] Open
Abstract
Background Stroke is a debilitating disease affecting millions of people worldwide. Despite the survival rate has significantly increased over the years, many stroke survivors are left with severe impairments impacting their quality of life. Rehabilitation programs have proved to be successful in improving the recovery process. However, a reliable model of sensorimotor recovery and a clear identification of predictive markers of rehabilitation-induced recovery are still needed. This article introduces the cross-modality protocols designed to investigate the rehabilitation treatment's effect in a group of stroke survivors. Methods/design A total of 75 stroke patients, admitted at the IRCCS San Camillo rehabilitation Hospital in Venice (Italy), will be included in this study. Here, we describe the rehabilitation programs, clinical, neuropsychological, and physiological/imaging [including electroencephalography (EEG), transcranial magnetic stimulation (TMS), and magnetic resonance imaging (MRI) techniques] protocols set up for this study. Blood collection for the characterization of predictive biological biomarkers will also be taken. Measures derived from data acquired will be used as candidate predictors of motor recovery. Discussion/summary The integration of cutting-edge physiological and imaging techniques, with clinical and cognitive assessment, dose of rehabilitation and biological variables will provide a unique opportunity to define a predictive model of recovery in stroke patients. Taken together, the data acquired in this project will help to define a model of rehabilitation induced sensorimotor recovery, with the final aim of developing personalized treatments promoting the greatest chance of recovery of the compromised functions.
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Affiliation(s)
- Silvia Salvalaggio
- IRCCS San Camillo Hospital, Venice, Italy
- Padova Neuroscience Center, Università degli Studi di Padova, Padua, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum – Università di Bologna, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | | | | | | | - Anna Maria Cortese
- Department of Rehabilitation Medicine, AULSS 3 Serenissima, Venice, Italy
| | | | | | | | | | - Eleonora Mascotto
- Department of Physical Medicine and Rehabilitation, Venice Hospital, Venice, Italy
| | | | | | | | - Anna Vedovato
- General Hospital San Camillo of Treviso, Treviso, Italy
| | - Sara Zago
- IRCCS San Camillo Hospital, Venice, Italy
| | - Marco Zorzi
- IRCCS San Camillo Hospital, Venice, Italy
- Padova Neuroscience Center, Università degli Studi di Padova, Padua, Italy
- Department of General Psychology, University of Padova, Padua, Italy
| | | | - Dante Mantini
- IRCCS San Camillo Hospital, Venice, Italy
- Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium
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Di Gregorio F, Petrone V, Casanova E, Lullini G, Romei V, Piperno R, La Porta F. Hierarchical psychophysiological pathways subtend perceptual asymmetries in Neglect. Neuroimage 2023; 270:119942. [PMID: 36796529 DOI: 10.1016/j.neuroimage.2023.119942] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/25/2023] [Accepted: 02/13/2023] [Indexed: 02/16/2023] Open
Abstract
Stroke patients with left Hemispatial Neglect (LHN) show deficits in perceiving left contralesional stimuli with biased visuospatial perception towards the right hemifield. However, very little is known about the functional organization of the visuospatial perceptual neural network and how this can account for the profound reorganization of space representation in LHN. In the present work, we aimed at (1) identifying EEG measures that discriminate LHN patients against controls and (2) devise a causative neurophysiological model between the discriminative EEG measures. To these aims, EEG was recorded during exposure to lateralized visual stimuli which allowed for pre-and post-stimulus activity investigation across three groups: LHN patients, lesioned controls, and healthy individuals. Moreover, all participants performed a standard behavioral test assessing the perceptual asymmetry index in detecting lateralized stimuli. The between-groups discriminative EEG patterns were entered into a Structural Equation Model for the identification of causative hierarchical associations (i.e., pathways) between EEG measures and the perceptual asymmetry index. The model identified two pathways. A first pathway showed that the combined contribution of pre-stimulus frontoparietal connectivity and individual-alpha-frequency predicts post-stimulus processing, as measured by visual-evoked N100, which, in turn, predicts the perceptual asymmetry index. A second pathway directly links the inter-hemispheric distribution of alpha-amplitude with the perceptual asymmetry index. The two pathways can collectively explain 83.1% of the variance in the perceptual asymmetry index. Using causative modeling, the present study identified how psychophysiological correlates of visuospatial perception are organized and predict the degree of behavioral asymmetry in LHN patients and controls.
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Affiliation(s)
- Francesco Di Gregorio
- UOC Medicina Riabilitativa e Neuroriabilitazione, Azienda Unità Sanitaria Locale, Bologna 40133, Italy
| | - Valeria Petrone
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Emanuela Casanova
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Giada Lullini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Vincenzo Romei
- Dipartimento di Psicologia, Centro Studi E Ricerche in Neuroscienze Cognitive, Alma Mater Studiorum - Università di Bologna, Campus di Cesena, Cesena 47521, Italy
| | - Roberto Piperno
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Fabio La Porta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
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Bellartz E, Pertz M, Jungilligens J, Kleffner I, Wellmer J, Schlegel U, Thoma P, Popkirov S. Point-of-Care Testing Using a Neuropsychology Pocketcard Set: A Preliminary Validation Study. Brain Sci 2022; 12:brainsci12060694. [PMID: 35741580 PMCID: PMC9221077 DOI: 10.3390/brainsci12060694] [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: 05/02/2022] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 02/05/2023] Open
Abstract
Neurocognitive screening instruments usually require printed sheets and additional accessories, and can be unsuitable for low-threshold use during ward rounds or emergency workup, especially in patients with motor impairments. Here, we test the utility of a newly developed neuropsychology pocketcard set for point-of-care testing. For aphasia and neglect assessment, modified versions of the Language Screening Test and the Bells Test were validated on 63 and 60 acute stroke unit patients, respectively, against expert clinical evaluation and the original pen-and-paper Bells Test. The pocketcard aphasia test achieved an excellent area under the curve (AUC) of 0.94 (95% CI: 0.88−1, p < 0.001). Using an optimal cut-off of ≥2 mistakes, sensitivity was 91% and specificity was 81%. The pocketcard Bells Task, measured against the clinical neglect diagnosis, achieved higher sensitivity (89%) and specificity (88%) than the original paper-based instrument (78% and 75%, respectively). Separately, executive function tests (modified versions of the Trail Making Test [TMT] A and B, custom Stroop color naming task, vigilance ‘A’ Montreal Cognitive Assessment item) were validated on 44 inpatients with epilepsy against the EpiTrack® test battery. Pocketcard TMT performance was significantly correlated with the original EpiTrack® versions (A: r = 0.64, p < 0.001; B: r = 0.75, p < 0.001). AUCs for the custom Stroop task, TMT A and TMT B for discriminating between normal and pathological EpiTrack® scores were acceptable, excellent and outstanding, respectively. Quick point-of-care testing using a pocketcard set is feasible and yields diagnostically valid information.
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Affiliation(s)
- Emily Bellartz
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany; (E.B.); (M.P.); (J.J.); (I.K.); (U.S.)
- Neuropsychological Therapy Centre (NTC)/Clinical Neuropsychology, Faculty of Psychology, Ruhr University Bochum, 44801 Bochum, Germany;
| | - Milena Pertz
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany; (E.B.); (M.P.); (J.J.); (I.K.); (U.S.)
| | - Johannes Jungilligens
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany; (E.B.); (M.P.); (J.J.); (I.K.); (U.S.)
| | - Ilka Kleffner
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany; (E.B.); (M.P.); (J.J.); (I.K.); (U.S.)
| | - Jörg Wellmer
- Ruhr-Epileptology, Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany;
| | - Uwe Schlegel
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany; (E.B.); (M.P.); (J.J.); (I.K.); (U.S.)
| | - Patrizia Thoma
- Neuropsychological Therapy Centre (NTC)/Clinical Neuropsychology, Faculty of Psychology, Ruhr University Bochum, 44801 Bochum, Germany;
| | - Stoyan Popkirov
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany; (E.B.); (M.P.); (J.J.); (I.K.); (U.S.)
- Correspondence:
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Errante A, Saviola D, Cantoni M, Iannuzzelli K, Ziccarelli S, Togni F, Simonini M, Malchiodi C, Bertoni D, Inzaghi MG, Bozzetti F, Menozzi R, Quarenghi A, Quarenghi P, Bosone D, Fogassi L, Salvi GP, De Tanti A. Effectiveness of action observation therapy based on virtual reality technology in the motor rehabilitation of paretic stroke patients: a randomized clinical trial. BMC Neurol 2022; 22:109. [PMID: 35317736 PMCID: PMC8939064 DOI: 10.1186/s12883-022-02640-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rehabilitation of paretic stroke patients uses a wide range of intervention programs to improve the function of impaired upper limb. A new rehabilitative approach, called action observation therapy (AOT) is based on the discovery of mirror neurons and has been used to improve the motor functions of adult stroke patients and children with cerebral palsy. Recently, virtual reality (VR) has provided the potential to increase the frequency and effectiveness of rehabilitation treatment by offering challenging and motivating tasks. METHODS: The purpose of the present project is to design a randomized controlled six-month follow-up trial (RCT) to evaluate whether action observation (AO) added to standard VR (AO + VR) is effective in improving upper limb function in patients with stroke, compared with a control treatment consisting of observation of naturalistic scenes (CO) without any action content, followed by VR training (CO + VR). DISCUSSION AO + VR treatment may provide an addition to the rehabilitative interventions currently available for recovery after stroke and could be utilized within standard sensorimotor training or in individualized tele-rehabilitation. TRIAL REGISTRATION The trial has been prospectively registered on ClinicalTrials.gov. NCT05163210 . 17 December 2021.
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Affiliation(s)
- Antonino Errante
- Diagnostic Department, Neuroradiology Unit, University Hospital of Parma, Via Volturno 39, 43125, Parma, Italy. .,Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Donatella Saviola
- Cardinal Ferrari Center, S. Stefano Riabilitazione, Fontanellato, Parma, Italy
| | - Matteo Cantoni
- Cardinal Ferrari Center, S. Stefano Riabilitazione, Fontanellato, Parma, Italy
| | - Katia Iannuzzelli
- Cardinal Ferrari Center, S. Stefano Riabilitazione, Fontanellato, Parma, Italy
| | | | - Fabrizio Togni
- Quarenghi Clinical Institute, San Pellegrino Terme, Bergamo, Italy
| | | | - Carolina Malchiodi
- Cardinal Ferrari Center, S. Stefano Riabilitazione, Fontanellato, Parma, Italy
| | - Debora Bertoni
- Cardinal Ferrari Center, S. Stefano Riabilitazione, Fontanellato, Parma, Italy
| | | | - Francesca Bozzetti
- Diagnostic Department, Neuroradiology Unit, University Hospital of Parma, Via Volturno 39, 43125, Parma, Italy
| | - Roberto Menozzi
- Diagnostic Department, Neuroradiology Unit, University Hospital of Parma, Via Volturno 39, 43125, Parma, Italy
| | | | - Paola Quarenghi
- Quarenghi Clinical Institute, San Pellegrino Terme, Bergamo, Italy
| | - Daniele Bosone
- Quarenghi Clinical Institute, San Pellegrino Terme, Bergamo, Italy
| | - Leonardo Fogassi
- Diagnostic Department, Neuroradiology Unit, University Hospital of Parma, Via Volturno 39, 43125, Parma, Italy
| | - Gian Piero Salvi
- Quarenghi Clinical Institute, San Pellegrino Terme, Bergamo, Italy
| | - Antonio De Tanti
- Cardinal Ferrari Center, S. Stefano Riabilitazione, Fontanellato, Parma, Italy
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A test of the unified model of vision and attention: Effects of parietal-occipital damage on visual orienting. Neuropsychologia 2022; 168:108185. [DOI: 10.1016/j.neuropsychologia.2022.108185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 01/23/2022] [Accepted: 02/16/2022] [Indexed: 10/19/2022]
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9
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Effects of Prism Adaptation on Reference Systems for Extrapersonal Space in Neglect Patients. Brain Sci 2019; 9:brainsci9110327. [PMID: 31744104 PMCID: PMC6896101 DOI: 10.3390/brainsci9110327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/06/2019] [Accepted: 11/14/2019] [Indexed: 11/21/2022] Open
Abstract
Up to now, rehabilitation of unilateral spatial neglect has focused on egocentric forms of neglect, whereas less is known about the possibility to improve allocentric deficits. The present study aimed to examine the efficacy of prism adaptation (PA) training on patients with different forms of neglect: egocentric, allocentric, or mixed. Twenty-eight patients were assessed with specific neglect tests before (T0) and after (T1) 10 sessions of PA training. Performance in the Apples Cancellation test was used to identify patients with egocentric (n = 6), allocentric (n = 5), or mixed (n = 17) forms of neglect. In the overall group of patients, PA training produced significant improvements in performance across different neglect tests. In terms of the egocentric–allocentric distinction, the training was effective in reducing omissions in the left part of space in the Apples Cancellation test both for patients with egocentric neglect and mixed neglect. By contrast, errors of commissions (marking the inability to detect the left part of the target stimulus, i.e., allocentric neglect) remained unchanged after PA in patients with allocentric neglect and actually increased marginally in patients with mixed neglect. The PA training is effective in improving egocentric neglect, while it is ineffective on the allocentric form of the disturbance. Notably, the allocentric component of neglect is frequently impaired, although this is most often in conjunction with the egocentric impairment, yielding the mixed form of neglect. This stresses the importance of developing exercises tuned to improving allocentric neglect.
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de Sire A, Baricich A, Ferrillo M, Migliario M, Cisari C, Invernizzi M. Buccal hemineglect: is it useful to evaluate the differences between the two halves of the oral cavity for the multidisciplinary rehabilitative management of right brain stroke survivors? A cross-sectional study. Top Stroke Rehabil 2019; 27:208-214. [DOI: 10.1080/10749357.2019.1673592] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Alessandro de Sire
- Physical and Rehabilitation Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
- Rehabilitation Unit, ‘Mons. L. Novarese’ Hospital, Moncrivello, Vercelli, Italy
| | - Alessio Baricich
- Physical and Rehabilitation Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
- Physical and Rehabilitation Medicine Unit, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Martina Ferrillo
- Department of Surgical Sciences, Specialization School of Orthodontics, Dental School, University of Turin, Turin, Italy
| | - Mario Migliario
- Dental Clinic, Department of Health Sciences, University of Eastern Piedmont ‘A. Avogadro’, Novara, Italy
| | - Carlo Cisari
- Physical and Rehabilitation Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
- Physical and Rehabilitation Medicine Unit, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Marco Invernizzi
- Physical and Rehabilitation Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
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