1,721,044 research outputs found
Efficacia a lungo termine della riabilitazione della negligenza spaziale unilaterale mediante lenti prismatiche: uno studio preliminare
No full textLa negligenza spaziale unilaterale (neglect), è un disturbo dell’attenzione selettiva spaziale e consiste nell’incapacità a prestare attenzione o a riconoscere stimoli posti nell’emispazio sinistro (Heilman, Bowers, Valenstein, & Watson, 1993; Mesulam, 1999; Vallar, 2007). In ambito riabilitativo, la negligenza spaziale unilaterale rappresenta un deficit di considerevole interesse per diversi motivi, in particolar modo per l’associazione con un minor recupero funzionale dopo ictus cerebrale destro ed una risposta meno favorevole al trattamento dell’emiparesi sinistra (Katz, Hartman-Maeir, Ring, & Soroker, 1999). Studi recenti evidenziano risultati positivi nella riabilitazione del neglect mediante l’utilizzo di lenti prismatiche (Frassinetti, Angeli, Meneghello, Avanzi, & Làdavas, 2002; Luauté et al. 2009; Serino, Angeli, Frassinetti, & Làdavas, 2006). E’ stato dimostrato che pazienti affetti da neglect, dopo un breve periodo di trattamento basato sull’adattamento visuo-motorio a lenti prismatiche, presentano una significativa riduzione nei deficit eminattentivi nei diversi settori dello spazio considerati (Frassinetti et al., 2002; Serino et al., 2006; Shiraishi, Muraki, Itou, & Hirayama, 2010). Il presente studio intende fornire ulteriori evidenze circa l’efficacia a lungo termine del trattamento, in termini di estensione del recupero a diversi tipi di prove e settori dello spazio. A tale scopo, sono stati reclutati nove pazienti cerebrolesi destri affetti da negligenza spaziale unilaterale conseguente a lesione vascolare riguardante l’emisfero destro. Il campione è costituito da cinque maschi e quattro femmine con età media di 48 anni (range 17-65), destrimani. La scolarità media del campione è di 9.5 anni (range 8-17). I pazienti sono stati sottoposti ad una batteria standard per la valutazione dei deficit visuo-spaziali (Behavioural Inattention Test). Mediante i differenti sub-test è stata valutata la presenza di neglect peripersonale, neglect rappresentazionale, dislessia da neglect ed agrafia visuospaziale. Sono stati inoltre utilizzati due test per valutare la presenza di neglect personale (Fluff Test e Comb and Razor Test). I pazienti sono stati sottoposti a un training basato sul metodo delle lenti prismatiche, della durata di due settimane e cadenza bi-giornaliera. I pazienti sono stati valutati prima e dopo il trattamento e ad una distanza media di 16.7 mesi (range otto mesi-due anni e sei mesi) dalla conclusione dello stesso. Le analisi condotte sui dati raccolti hanno evidenziato, in seguito al trattamento, un miglioramento globale delle prestazioni alle prove somministrate; tale miglioramento si è mantenuto, nella maggior parte delle prove, nella valutazione di follow-up, dove sono stati osservati ulteriori incrementi dei punteggi
Modulation of visuo-spatial attention by means of emotional facial and bodily expressions: theoretical basis and empirical evidence
Full text linkFaces and bodies are both efficient in communicating emotions and attracting attention automatically. However, faces seem especially informative when seen in the near space, whereas bodies are particularly effective in the far space.In the patient’s subgroup showing near-space neglect, a significant effect in reducing rightward bisection errors was found with both fearful and happy facial expressions presented in the near space, and with fearful and happy bodies presented in the far space. Conversely, in the patient’s subgroup showing far-space neglect, the most consistent reduction was observed for left-side fearful bodies shown in the far space. No significant effect was found with regard to healthy participants.Fearful, happy and neutral facial or bodily expressions were used as lateral cues during a line bisection task. We studied 24 spatial neglect patients, 19 with a prevailing deficit in the near space and 5 with deficit in the far space. Besides, a 20 healthy participants group was recruited. Lines could be placed either near (60 cm) or far (150 cm) from the patients, who were asked to mask the midpoint regardless of the presence or nature of the lateral cues.The present work bases on the available literature, showing that fearful and happy facial and bodily expressions may summon attention and overcome leftward bias in patients with hemispatial neglect. Here we tested the biologically-inspired hypothesis that faces are more effective than bodies in reducing neglect when presented in the near space, whereas bodily expressions are more effective when displayed in the far space
Cognitive and behavioural deficits following bilateral thalamic stroke: a longitudinal study
No full textWe describe behavioral and neuropsychological outcome of a patient (N.S.), who showed a bilateral paramedian thalamic ischemic lesion, with particular reference to the longitudinal evolution of topographical disorientation (TD) and confabulations. We report clinical neuropsychological/behavioral data over a 43-month follow-up. The results show early after the stroke a severe amnesic-confabulatory syndrome with dysexecutive deficits, associated with memory disorders both for visuo-spatial and verbal materials and TD both for known and new places. Behavioral disinhibition and anosognosia for cognitive deficits were also observed. All cognitive impairments have been recovered during the long-term follow-up. Bilateral paramedian thalamic infarcts often lead to severe and long-lasting neurological and cognitive impairments. Only a few cases showed good recovery. Our patient represents an interesting and uncommon case of bilateral paramedian thalamic syndrome with a significant neuropsychological recovery
Topographical abilities, neuropsychological and self-activation correlates of bilateral thalamic lesion.
No full text
Post stroke cognitive assessment and rehabilitation: A new ecological virtual reality task.
No full textLong-Term efficacy of prism adaptation on spatial Neglect: preliminary results on different spatial components
Full text linkThis study describes the long-term effectiveness on spatial neglect recovery of a 2-week treatment based on prism adaptation (PA). Seven right-brain-damaged patients affected by chronic neglect were evaluated before, after two weeks of the PA treatment and at a follow-up (variable between 8 and 30 months after the end of PA). Neglect evaluation was performed by means of BIT (conventional and behavioral), Fluff Test, and Comb and Razor Test. The results highlight an improvement, after the PA training, in both tasks performed using the hand trained in PA treatment and in behavioral tasks not requiring a manual motor response. Such effects extend, even if not significantly, to all BIT subtests. These results support previous findings, showing that PA improves neglect also on imagery tasks with no manual component, and provide further evidence for long-lasting efficacy of PA training. Dissociations have been found with regard to PA efficacy on peripersonal, personal, and representational neglect, visuospatial agraphia and neglect dyslexia. In particular, we found no significant differences between the pre-training and post-training PA session in personal neglect measures, and a poor recovery of neglect dyslexia after PA treatment. The recruitment of a larger sample could help to confirm the effectiveness of the prismatic lenses with regard to the different clinical manifestations of spatial neglect
Egocentric and allocentric coordinates in disorders of spatial memory, spatial exploration/representation in acute stroke
No full textThis chapter describes the investigation of egocentric/allocentric spatial memory components in acute stroke phase, according to patients’ lesion sites, with the aim to highlight correlations between egocentric/allocentric deficits in spatial exploration and spatial representation, with particular reference to visuo-spatial neglect
A NeuroVR based tool for cognitive assessment and rehabilitation of post-stroke patients: two case studies
No full textNeuropsychological disorders are common in stroke patients, ranging from an isolated impairment to impairment in multiple cognitive functions. The cognitive domains affected are in particular executive functions. These comprise planning, organising, conducting, assessing and controlling actions. Dual task abilities, that is the ability to perform successive or simultaneous tasks, are not easy to be evaluated and recovered by traditional paper and pencil methods, due to their ecological and contextual nature. NeuroVR 1.5 is a cost-free virtual reality platform based on open-source software, allowing professionals to easily modify a virtual world, to best suit the needs of the clinical setting.The present study was designed to develop and test a NeuroVR based tool for the rehabilitation of shifting of attention and action planning functions using tasks reminiscent of daily life tasks. We present the virtual environment and the cognitive procedure we developed, discussing two stroke patients case studies, which underwent an integrated neuropsychological and VR assessment
Implementation of the Multiple Errands Test in a NeuroVR supermarket: A possible approach
No full textOur goal was to develop a tool for the assessment of executive functions by customizing a virtual reality (VR) version of the Multiple Errands Test (MET) [Shallice & Burgess, 1991; Fortin et al., 2003]. The MET is an assessment of executive functions in daily life which consists of tasks that abide by certain rules. It is performed in an actual shopping mall-like setting where there are items to be bought and information to be obtained. The specific goal of this study was to conduct a pilot study using the virtual version of MET (VMET) with both control subjects and patients with cognitive impairment derived from stroke
- …
