Assessment of language lateralization in epilepsy patients using the super-selective Wada test.

BACKGROUND: The classical Wada test (cWada), performed by injecting a short-acting anesthetic through the intracarotid route, helps determine language dominance. In the cWada, adverse effects are observed in 10-30% of trials, hindering accurate assessments. In this study, we assessed the effectiveness of the super-selective Wada test (ssWada), a more selective approach for anesthetic infusion into the middle cerebral artery (MCA). METHODS: We retrospectively examined the data of 17 patients with epilepsy who underwent ssWada via anesthetic injection into one M1 segment of the MCA and at least one contralateral trial. RESULTS: The ssWada identified 12 patients with left language dominance, 3 with right language dominance, and 2 with bilateral language distribution. Nine trials on the language dominant side resulted in global aphasia for patients with left- or right language dominance. Of the 13 trials conducted on the non-dominant language side, 12 revealed intact language function and one resulted in confusion. Among these, the outcomes of global aphasia or no language impairment were confirmed in the contralateral trials. Among the 22 trials of unilateral M1 injections in patients with unilateral language dominance, 21 (95.5%) showed either global aphasia or no language impairment, indicating language dominance. CONCLUSIONS: The ssWada yields clear results, with a high rate of over 90% in determining the language dominant hemisphere with few side effects.

Super-selective Wada test for pre-surgical leg motor function assessment: A case report.

INTRODUCTION: Wada test is well-known to assess lateralization of memory and language functions; however, super-selective Wada (ss-Wada) to evaluate motor leg function is rare. We present a ss-Wada test within the anterior cerebral artery (ACA) to assess the motor function of the leg. METHODS: Retrospective chart review. RESULTS: Comprehensive phase-I/II surgical evaluation revealed an ictal focus around the left post-central gyrus with immediate involvement around the left para-central regions. To avoid potential right leg motor dysfunction with the surgery, the patient underwent a ss-Wada procedure. Angiography revealed bilateral ACAs were supplied by the left A1 segment. Super-selective microcatheter injection of amobarbital into the left ACA was performed to avoid cross-filling the contralateral ACA. The ss-Wada test confirmed no right leg motor impairment. Afterward, a craniotomy with direct cortical stimulation confirmed that the left-sided ictal/peri-ictal zone had no clear leg motor function. The patient underwent disconnection of that region and remained seizure-free at 10-month post-op follow-up without any motor or sensory deficits in the right limbs. CONCLUSION: This case demonstrates the proof of concept for ss-Wada in assessing lower extremity motor function. The ss-Wada procedure accurately predicted no motor deficits in the right leg, consistent with preserved motor function post-surgery.

Exploring the comparative adequacy of a unimanual and a bimanual stimulus-response setup for use with three-alternative choice response time tasks.

Research often conceptualises complex social factors as being distinct binary categories (e.g., female vs male, feminine vs masculine). While this can be appropriate, the addition of an 'overlapping' category (e.g., non-binary, gender neutral) can contextualise the 'binary', both for participants (allowing more complex conceptualisations of the categories than the 'either/or' conceptualisation in binary tasks), and for the results (by providing a neutral baseline for comparison). However, it is not clear what the best response setup for such a task would be. In this study, we explore this topic through comparing a unimanual (N = 34) and a bimanual response setup (N = 32) for use with a three-alternative choice response time task. Crucially, one of the stimulus categories ('mixed') was composed of stimulus elements from the other two stimulus categories used in that task (Complex Task). A reference button task was included to isolate the motoric component of response registration (Simple Task). The results of the simple task indicated lower motoric costs for the unimanual compared to the bimanual setup. However, when statistically controlling for these motoric costs in the complex task, the bimanual setup had a lower error rate and faster response times than the unimanual setup. Further, in the complex task error rates and response times were higher for the mixed than the matched stimuli, indicating that responding to mixed stimuli is more challenging for encoding and/or decision making processes. This difference was more pronounced in the unimanual than the bimanual setup. Taken together these results indicate that the unimanual setup is more adequate for the reference button task, whereas the intricacy of overlapping categories in the complex task is better contained in the bimanual setup, i.e. when some response alternatives are allocated to one hand and other alternatives to the other hand.

An immersive virtual reality system for ecological assessment of peripersonal and extrapersonal unilateral spatial neglect.

BACKGROUND: Unilateral spatial neglect (USN) is a debilitating neuropsychological syndrome that often follows brain injury, in particular a stroke affecting the right hemisphere. In current clinical practice, the assessment of neglect is based on old-fashioned paper-and-pencil and behavioral tasks, and sometimes relies on the examiner's subjective judgment. Therefore, there is a need for more exhaustive, objective and ecological assessments of USN. METHODS: In this paper, we present two tasks in immersive virtual reality to assess peripersonal and extrapersonal USN. The tasks are designed with several levels of difficulty to increase sensitivity of the assessment. We then validate the feasibility of both assessments in a group of healthy adult participants. RESULTS: We report data from a study with a group of neurologically unimpaired participants (N = 39). The results yield positive feedback on comfort, usability and design of the tasks. We propose new objective scores based on participant's performance captured by head gaze and hand position information, including, for instance, time of exploration, moving time towards left/right and time-to-reach, which could be used for the evaluation of the attentional spatial bias with neurological patients. Together with the number of omissions, the new proposed parameters can result in lateralized index ratios as a measure of asymmetry in space exploration. CONCLUSIONS: We presented two innovative assessments for USN based on immersive virtual reality, evaluating the far and the near space, using ecological tasks in multimodal, realistic environments. The proposed protocols and objective scores can help distinguish neurological patients with and without USN.

Pressure Sensors for Measuring the Grip Pressure during Kendo Attacks: Assessment of Laterality and Evidence of the Five Phases of Attack.

In Kendo, there is no consensus as to which hand should produce more pressure when attacking the opponent with the bamboo sword, let alone how to teach the pressure distribution during coaching. There is the theory that a Kendo attack can be divided into five phases, which has not entered the coaching practice, either. The aim of this study was to measure the grip pressure during Kendo attacks, investigate the pressure distribution between the two hands, and find evidence for the existence of the alleged five attack phases. We instrumented a bamboo sword with grip pressure sensors and investigated the grip pressure in 23 participants. In all attack targets and in both hands, the pressure across all attack phases was significantly different. In general, the left-hand pressure was consistently and significantly higher than the right-hand one, across all five attack phases, for the hand, head, and flank attack targets. The surprising exception was the throat target with only two attack phases, the strike phase of which showed a greater pressure in the right hand. Across all participants, the left-hand pressure was greater in 60.22-100% in any phase of the four attack targets, except for the strike phase of the throat target. Through these results, we could verify the effect of the teaching customs in Kendo, as well as provide first-time evidence of the existence of the five attack phases.

Clinical assessment of unilateral spatial neglect dissociations and heterogeneities: A narrative synthesis.

OBJECTIVE: Unilateral spatial neglect (USN) is a neuropsychological syndrome whose symptoms differ considerably between patients. Several heterogeneities and dissociations have been described between processing stages, spatial regions, reference frames, or sensory modalities. However, in clinical practice, current routine tests rarely assess the different USN subtypes. There is a real lack of practice guidance for clinicians to help them choosing the right USN assessment tools for specific USN aspects. METHOD: The present article is a narrative synthesis based on a systematic literature search of (a) the dissociations and heterogeneities that can appear in USN and of (b) the different clinical tools available for their assessment. RESULTS: Several tools have been developed to better assess USN heterogeneities. This review highlights their potential relevance and advocates for their widespread use in a clinical practice context. However, it also raised the issue of the lack of standardized clinical tools for the evaluation of some USN aspects. CONCLUSION: While USN heterogeneities and dissociations are difficult to assess in current clinical practice, there is a real need to improve their assessment. This will allow clinicians to establish the individual USN profile of each patient not only in terms of severity but also of impaired aspects in order to provide them the rehabilitation program that suits the best their needs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Development and test-retest reliability assessment of a low-cost, 3D printed tool for assessing different aspects of hand dexterity.

BACKGROUND: Hand dexterity assessments related to fine motor movements are routinely administered in clinical settings to ascertain an individual's hand function. However, to perform a detailed assessment multiple devices are needed which can be time-consuming and costly to administer. PURPOSE: We designed and assessed the test-retest reliability of a 3D printed dexterity device in a cohort of healthy young adults and community-dwelling older adults. This study examines the reliability of the device, association between perceived fine motor gripping and manipulation dexterity components, and dominant hand outperformance during both tasks. STUDY DESIGN: Test-retest study of a clinical measurement tool. METHODS: A convenience sample of thirty-six healthy community-dwelling older and young adults was included in our study. The device was used to collect data at two testing sessions to establish test-retest reliability. Fine motor manipulation dexterity was assessed by lifting notched pegs over a vertical barrier and inserting them into randomly oriented holes sequentially. Fine motor gripping dexterity was assessed by taking these notched pegs out of the holes, lifting them over the barrier and dropping them into a large container. RESULTS: Intraclass correlation coefficient (ICC)2,1 showed good to excellent test-retest reliability on the dominant and nondominant hands when using the device. Only modest association was found within-hand for the gripping versus manipulation dexterity tests. The between-hand motor gripping dexterity test demonstrated a strong association; however, between-hand the motor manipulation dexterity test was only moderately associated. CONCLUSION: The device was reliable, discriminated between the motor gripping and motor manipulating dexterity tasks, and was sensitive to handedness during the motor manipulating dexterity task. It shows promise as a hand dexterity assessment device which may provide efficiency and cost advantages. It is freely available via http://www.rehabtools.org/dexterity.html.

Notas sobre o pesquisar em cena(s) / Notes on researching in scenes / Notas sobre la investigación en escena(s)

O presente artigo tem como objetivo apresentar a construção metodológica desenvolvida em uma pesquisa de mestrado, na qual sustentamos a escrita de cenas como método de pesquisa da escuta clínica. As cenas do trabalho em questão foram recolhidas ao longo do tempo, no contorno da experiência de um projeto de extensão universitária de atenção à infância e adolescência em situação de vulnerabilidade social, situado em uma comunidade periférica. Apresentamos, neste texto, as interrogações que se elaboraram em torno da escolha pelo trabalho com cenas, e compartilhamos o resgate histórico dessas como um método de escrever a clínica, bem como a retomada de sua análise a partir da tradição psicanalítica. Amparadas nesta teoria e em leituras e contribuições do filósofo francês Jacques Derrida, embasamos a noção de que a cena se constitui como um lugar de produção, ao engendrar a configuração particular de elementos significantes nos processos de subjetivação e de construção social. A cena não é, então, compreendida aqui como uma representação do que acontece na clínica, mas como um modo de produzir a escuta e os seus processos de investigação.(AU)

This article aims to present the methodological construction developed in a master's research, in which the writing of scenes as a method of clinical listening research was endorsed. The scenes from the study in question were collected over time, from the experience gained in a project conducted within a university extension program on care in childhood and adolescence in social vulnerability, in a peripheral community. In this study, we present some questions that were elaborated surrounding the choices of working with scenes; and we share the historical rescue of this work as a method of writing on clinic practices and resuming their analysis from the psychoanalytic tradition. Based on the psychoanalytic theory and on the readings and contributions of the French philosopher Jacques Derrida, we corroborate the notion that the scene is constituted as a place of production, engendering the particular configuration of significant elements in the processes of subjectivation and social construction. Here, the scene is not a representation of clinical practice but one mode of producing listening and its research processes.(AU)

Este artículo tiene como objetivo presentar la construcción metodológica desarrollada en una investigación de maestría, en la que sostenemos la escritura de escenas como método de investigación de la escucha clínica. Las escenas del trabajo en cuestión se recogieron a lo largo del tiempo desde la experiencia en un proyecto de extensión universitario de atención a la niñez y adolescencia en situación de vulnerabilidad social aplicado en una comunidad periférica. En este texto, presentamos los interrogantes que se elaboraron en torno a la elección por el trabajo con escenas y compartimos el rescate histórico de las mismas como un método de escribir la clínica y la reanudación del análisis a partir de la tradición psicoanalítica. Amparadas en el psicoanálisis y en lecturas y contribuciones del filósofo francés Jacques Derrida, nos basaremos en la noción de que la escena se constituye como un lugar de producción, engendrando la configuración particular de elementos significantes en los procesos de subjetivación y de construcción social. La escena no es aquí una representación de lo que pasa en la clínica, sino un modo de producir escucha y sus procesos de investigación.(AU)

Environmental innovation ambidexterity and customer relationship performance: evidence from the manufacturing industry in China.

Cleaner production and pollution prevention are not only essential for enterprises to improve resource utilization efficiency and competitiveness, but also realistic requirements for enterprises to comply with green manufacturing policies and regulations. Many previous studies have investigated the impacts of environmental innovation on products and environmental performance, but few of them have explored the impact of environmental innovation on customer relationships. The main purpose of this study is to investigate the basic strategies to enhance customer relationship in the context of green development. Building upon the resource-based view, the dynamic capability perspective, and the upper echelons theory, this study develops a conceptual model focusing on the effects of environmental innovation ambidexterity (EIA) on customer relationship performance (CRP), the mediating effects of green product innovation (GPI), and the moderating role of top management's environmental awareness. The results of a survey of 285 high-tech manufacturing enterprises in China show that EIA has a positive effect on CRP. The results of the study also indicate that GPI mediates the relationship between EIA and CRP, and top management's environmental awareness moderates the impact of EIA on CRP. The results offer novel insights for suppliers to improve CRP, and provide theoretical guidance for high-tech manufacturing enterprises to effectively implement pollution prevention and GPI.

The Handedness Index Practical Task (HI20): An economic behavioural measure for assessing manual preference.

ABSTRACTBecause self-report hand preference measures are limited to investigating cognitive aspects of manual laterality, valid, easy-to-administer and economic behavioural methods are needed for capturing the motoric component of handedness. Therefore, this study introduces the Handedness Index Practical Task (HI20) and tests it in a sample of 206 students (Mage = 23.79 years, SDage = 3.01 years), half of whom were self-specified left-handers. After confirming good reliabilities at the subscale and total scale levels, k-means cluster analysis allowed an empirically based partitioning of test subjects into left- (n = 72), mixed- (n = 23) and right-handers (n = 111). To validate this categorization and the HI20 index, data were compared with the Edinburgh Handedness Inventory (EHI), EHI-short, HI22 and hand grip strength. The congruency between the HI20 clusters and alternative categorizations ranged from 95.6% to 84.0%, while the clusters explained large portions of variance in grip strength differences. The HI20 sub- and total scores showed strong correlations with other measures of lateral preference. Altogether, the freely available HI20 emerges as a reliable and valid alternative for behavioural handedness assessment, whose power lies in explaining differential hand use patterns and enabling fine-grained examinations of handedness.

A novel computerized assessment of manual spatial exploration in unilateral spatial neglect.

Unilateral spatial neglect is a neuropsychological syndrome commonly observed after stroke and defined by the inability to attend or respond to contralesional stimuli. Typically, symptoms are assessed using clinical tests that rely upon visual/perceptual abilities. However, neglect may affect high-level representations controlling attention in other modalities as well. Here we developed a novel manual exploration test using a touch screen computer to quantify spatial search behaviour without visual input. Twelve chronic stroke patients with left neglect and 27 patients without neglect (based on clinical tests) completed our task. Four of the 12 "neglect" patients exhibited clear signs of neglect on our task as compared to "non-neglect" patients and healthy controls, and six other patients (from both groups) also demonstrated signs of neglect compared to healthy controls only. While some patients made asymmetrical responses on only one task, generally, patients with the strongest neglect performed poorly on multiple tasks. This suggests that representations associated with different modalities may be affected separately, but that severe forms of neglect are more likely related to damage in a common underlying representation. Our manual exploration task is easy to administer and can be added to standard neglect screenings to better measure symptom severity.

Clinical course of left spatial neglect with a focus on the assessment of stimulus-driven attention.

We developed Stimulus-driven Attention Tests (SAT) for a patient with unilateral spatial neglect (USN) and longitudinally investigated the results and compared them to two conventional assessments. The patient suffered a right putaminal hemorrhage resulting in left-side USN. On the 12th, 22nd, and 28th days from the onset, the Behavioral Inattention Test (BIT) and the Catherine Bergego Scale (CBS), which are conventional USN assessments, and our two Stimulus-driven Attention Tests (SAT-1 and SAT-2) were performed. Our assessment tests comprise two tasks in which participants respond to suddenly appearing stimuli and to a target stimulus among distractors. A longitudinal comparison of all assessments was performed to observe the clinical course of the USN. On the 12th day, scores were low on the BIT, CBS, and both SATs, but on the 22nd day, BIT improved above the cutoff; however, the CBS and SATs did not improve. On the 28th day, response to a target stimulus among distractors in the SAT remained low, and CBS scores did not change significantly. We were able to detect USN with the SAT when the participant showed improvement on the paper-and-pencil tests. Moreover, the number of distractors in the SAT was thought to reveal covert USN.

Audiospatial evoked potentials for the assessment of spatial attention deficits in patients with severe cerebrovascular accidents.

INTRODUCTION: Neuropsychological assessment of spatial orientation in post-acute patients with large brain lesions is often limited due to additional cognitive disorders like aphasia, apraxia, or reduced responsiveness. METHODS: To cope with these limitations, we developed a paradigm using passive audiospatial event-related potentials (pAERPs): Participants were requested to merely listen over headphones to horizontally moving tones followed by a short tone ("target"), presented either on the side to which the cue moved or on the opposite side. Two runs of 120 trials were presented and we registered AERPs with two electrodes, mounted at C3 and C4. Nine sub-acute patients with large left hemisphere (LH) or right hemisphere (RH) lesions and nine controls participated. RESULTS: Patients had no problems completing the assessment. RH patients showed a reduced N100 for left-sided targets in all conditions. LH patients showed a diminished N100 for invalid trials and contralesional targets. CONCLUSION: Measuring AERPs for moving auditory cues and with two electrodes allows investigating spatial attentional deficits in patients with large RH and LH lesions, who are often unable to perform clinical tests. Our procedure can be implemented easily in an acute and rehabilitation setting and might enable investigating spatial attentional processes even in patients with minimal conscious awareness.

Two-point discrimination assessment of the lower extremities of healthy young Turkish individuals.

OBJECTIVES: To investigate the normative two-point discrimination (TPD) values of the lower extremities of healthy young Turkish individuals. PATIENTS AND METHODS: Fifty-five healthy, young adults were recruited in this prospective study. Ten lower extremity parts were tested with esthesiometer: proximal thigh, midlateral thigh, midmedial thigh, midposterior thigh, proximal lateral leg, distal lateral leg, medial leg, the tip of great toe, skin over 1-2 metatarsal interspace, skin over 5th metatars at both dominant and non-dominant sides. RESULTS: There were 27 (49.1%) female and 28 (50.9%) male participants with a mean age of 22.06 ± 1.76 years. The reference values of the TPD of the lower extremities were between 42.4 ± 5.4 mm and 4.0 ± 1.3 mm by females and between 42.6 ± 6.4 mm and 4.4 ± 2.4 mm by males. Test values in the combined group of men and women were statistically greater at the dominant sides than the non-dominant sides at the following areas: proximal lateral leg (p = 0.01), distal lateral leg (p = 0.046), medial leg (p = 0.001), tip of great toe (p = 0.02), skin over 1-2 metatarsal interspace (p = 0.010), skin over 5th metatars (p = 0.002). There was no statistical difference in the test scores of men and women in any of the measured areas, with additional evaluation of both the dominant and the non-dominant sides (p > 0.05). CONCLUSION: The results of the present study demonstrated that TPD ability varied in different skin areas within the same individual. We found that laterality, though with lower scores on the non-dominant side in some lower extremity parts, but not the gender had an effect on TPD.

Manual praxis and language-production networks, and their links to handedness.

While Liepmann was one of the first researchers to consider a relationship between skilled manual actions (praxis) and language for tasks performed "freely from memory", his primary focus was on the relations between the organization of praxis and left-hemisphere dominance. Subsequent attempts to apply his apraxia model to all cases he studied - including his first patient, a "non-pure right-hander" treated as an exception - left the praxis-handedness issue unresolved. Modern neuropsychological and recent neuroimaging evidence either showed closer associations of praxis and language, than between handedness and any of these two functions, or focused on their dissociations. Yet, present-day developments in neuroimaging and statistics allow us to overcome the limitations of the earlier work on praxis-language-handedness links, and to better quantify their interrelationships. Using functional magnetic resonance imaging (fMRI), we studied tool use pantomimes and subvocal word generation in 125 participants, including righthanders (NRH = 52), ambidextrous individuals (mixedhanders; NMH = 31), and lefthanders (NLH = 42). Laterality indices were calculated both in two critical cytoarchitectonic maps, and 180 multi-modal parcellations of the human cerebral cortex, using voxel count and signal intensity, and the most relevant regions of interest and their networks were further analyzed. We found that atypical organization of praxis was present in all handedness groups (RH = 25.0%, MH = 22.6%; LH = 45.2%), and was about two and a half times as common as atypical organization of language (RH = 3.8%; MH = 6.5%; LH = 26.2%), contingent on ROI selection/LI-calculation method. Despite strong associations of praxis and language, regardless of handedness and typicality, dissociations of atypically represented praxis from typical left-lateralized language were common (~20% of cases), whereas the inverse dissociations of atypically represented language from typical left-lateralized praxis were very rare (in ~2.5% of all cases). The consequences of the existence of such different phenotypes for theoretical accounts of manual praxis, and its links to language and handedness are modeled and discussed.

Investigating information processing of the bimanual asymmetric cost with the response priming technique.

Constraining the degrees of freedom simplifies the coordinative challenge of bimanual asymmetric movements. This, however, comes at the cost of increased processing demands during movement preparation, referred to as the bimanual asymmetric cost. The goal of the present study was to further investigate information processing of the bimanual asymmetric cost with the response priming technique. This technique involved precuing a movement to encourage it to be preprogrammed. A different movement is occasionally cued by the go signal, which required the preprogrammed movement to be reprogrammed. In Experiment 1, 2 preprogrammed unimanual movements were reprogrammed, or integrated, into a bimanual movement. In Experiment 2, a preprogrammed bimanual movement was reprogrammed, or de-integrated, into a unimanual movement. Both experiments revealed 2 costs when integrating or de-integrating bimanual movements. One cost was likely related to aborting 1 movement and preparing another, which is the typical reprogramming cost found in response priming experiments. The second cost was likely related to constraining the degrees of freedom of bimanual asymmetric movements, which is a bimanual asymmetric cost. Integrating 2 unimanual movements into a bimanual asymmetric movement involves constraining the degrees of freedom, and de-integrating a bimanual asymmetric movement into a unimanual movement involves unconstraining the degrees of freedom. Both reprogramming and bimanual asymmetric costs occurred in 1 of the experimental conditions, and the interesting finding was that their effects were additive. Additive costs suggest that each cost affects a different stage of movement preparation. We suggest that the bimanual asymmetric cost occurs during response selection. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Unilateral Stroke: Computer-based Assessment Uncovers Non-Lateralized and Contralesional Visuoattentive Deficits.

OBJECTIVE: Patients with unilateral stroke commonly show hemispatial neglect or milder contralesional visuoattentive deficits, but spatially non-lateralized visuoattentive deficits have also been reported. The aim of the present study was to compare spatially lateralized (i.e., contralesional) and non-lateralized (i.e., general) visuoattentive deficits in left and right hemisphere stroke patients. METHOD: Participants included 40 patients with chronic unilateral stroke in either the left hemisphere (LH group, n = 20) or the right hemisphere (RH group, n = 20) and 20 healthy controls. To assess the contralesional deficits, we used a traditional paper-and-pencil cancellation task (the Bells Test) and a Lateralized Targets Computer Task. To assess the non-lateralized deficits, we developed a novel large-screen (173 × 277 cm) computer method, the Ball Rain task, with moving visual stimuli and fast-paced requirements for selective attention. RESULTS: There were no contralesional visuoattentive deficits according to the cancellation task. However, in the Lateralized Targets Computer Task, RH patients missed significantly more left-sided than right-sided targets in bilateral trials. This omission distribution differed significantly from those of the controls and LH patients. In the assessment of non-lateralized attention, RH and LH patients missed significantly more Ball Rain targets than controls in both the left and right hemifields. CONCLUSIONS: Computer-based assessment sensitively reveals various aspects of visuoattentive deficits in unilateral stroke. Patients with either right or left hemisphere stroke demonstrate non-lateralized visual inattention. In right hemisphere stroke, these symptoms can be accompanied by subtle contralesional visuoattentive deficits that have remained unnoticed in cancellation task.

Laterality for the next decade: Costs and benefits of neuronal asymmetries - putting lateralization in an evolutionary context.

In my comment on the target article of Ocklenburg et al. [Laterality 2020: Entering the next decade. Laterality, 1-33. doi:10.1080/1357650X.2020.1804396], I point out the relevance of studies in non-human species within natural settings for understanding the ecological pressures, which shape the direction and degree of brain asymmetries. I therefore outline some major research projects, which are not included in the paper of Ocklenburg et al. and which require comparative animal research.

Assessment of mirror movements in children and adolescents with unilateral cerebral palsy: reliability of the Woods and Teuber scale.

AIM: To investigate the inter- and intrarater reliability of the Woods and Teuber scale to detect mirror movements in children and adolescents with unilateral cerebral palsy (CP). METHOD: A convenience sample of children and adolescents with unilateral CP (n=68; 31 males, 37 females; mean age 12y 2mo, SD 3y 6mo) in Manual Ability Classification levels I to III was recruited from Norway, Australia, and Belgium. Three therapists scored mirror movements according to the Woods and Teuber scale from three video-recorded tasks at two separate time points. A two-way, mixed model regression was used to calculate intraclass correlation coefficients (ICCs) reflecting overall inter- and intrarater reliability. In addition, ICCs for each hand and task were calculated separately. RESULTS: The overall interrater reliability ICC was 0.90 and the corresponding intrarater reliability ICC was 0.92. The ICCs for each hand ranged from 0.86 to 0.92 and for each task from 0.63 to 0.89. INTERPRETATION: The Woods and Teuber scale shows excellent reliability for scoring mirror movements in children and adolescents with unilateral CP. The assessment is easy to administer with no need for specific equipment and scoring can be determined from short video recordings, making it a feasible instrument in research and clinical practice.

Dissociation between visuospatial neglect assessment tasks and its neuroanatomical substrates: a case report.

Visuospatial neglect possesses significant heterogeneity in clinical features and neuroanatomical substrates. Behavioral dissociations on different neglect tasks have been reported in the past, and the investigation of their respective anatomical correlates at cortical and, to a lesser degree, subcortical levels has been attempted in stroke studies. We report a patient with a neoplasm occupying the right ventral post-central gyrus and anterior supramarginal gyrus. The patient was admitted preoperatively with dissociation on the performance of neglect tasks, showing clinical deficits in the line bisection task and clock drawing, but not on the cancelation task. The patient underwent an awake craniotomy for tumor excision. Intraoperative visuospatial mapping was employed by applying direct electrical stimulation (DES) to the supramarginal gyrus and the ventral branch of the superior longitudinal fasciculus (SLF III) during the line bisection task. According to our findings, DES was ineffective at the cortical level, but it induced strong rightward bias when applied subcortically at the SLF III. By combining our preoperative and intraoperative anatomical and clinical data, we suggest that the posterior part of the SLF III might have a distinct role in the perceptual component of neglect. Our findings are discussed within the context of previous literature supporting the notion that particular behavioral features of spatial neglect are mediated by different white-matter connections.