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BACKGROUND: Visual snow syndrome (VSS) is a poorly understood neurological condition of unclear etiology, characterized by visual and non-visual symptoms that reduce quality of life. The objective of our study was to estimate the prevalence of young adults with visual snow in Russia. MATERIALS AND METHODS: We conducted an online survey among 1,177 respondents over the age of 18 residing in Russia. The questionnaire was based on MIDAS, HIT-6, ICHD-3, GAD-7, CES-D. RESULTS: A total of 1085 individuals, divided into three groups: 48 participants with Visual Snow Syndrome (VSS), 36 participants with visual snow symptoms (VS), and 1001 participants without visual snow (control group). Tinnitus (p<0.001) and paresthesia (p<0.001) were more common in participants with VSS compared to the control group. VSS group also reported mood disorders more frequently than those in the other groups (29.2% VSS, 13.9% VS, 7.0% control, p<0.001). Additionally, VSS group exhibited more elevated anxiety levels on the GAD-7 scale compared to the other groups (p=0.005), suggesting a weak association between anxiety and VSS. CONCLUSIONS: Diagnosed migraine, tinnitus, concentration problems, paresthesia, and verified psychiatric conditions were significantly more prevalent in the VSS group in our study. Tinnitus was significantly more frequent in the VS group. Diagnosed conditions across all ICD-10 classes were more frequently identified in the VSS group, with the strongest associations (moderate) found with ICD-10 codes: F80-F89 and F60-F69. Additionally ICD-10 codes F30-F39 were more frequently found in the VS group compared to the control group. Our study revealed that nearly all individuals with VSS in our sample (89.6%) had experienced symptoms for as long as they can remember. The prevalence of VS symptoms in Russia is 7.7% (6.2-9.3%) and VSS is 4.4% (3.2-5.7%).
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Acúfeno , Humanos , Federación de Rusia/epidemiología , Masculino , Femenino , Adulto Joven , Adulto , Prevalencia , Acúfeno/epidemiología , Adolescente , Parestesia/epidemiología , Síndrome , Trastornos Migrañosos/epidemiología , Trastornos de la Percepción , Trastornos de la VisiónRESUMEN
Purpose: Palinopsia (persistent afterimages and/or trailing) is a common but poorly understood symptom of the neurological condition visual snow syndrome. This study aimed to collect a phenotypical description of palinopsia in visual snow syndrome and probe for abnormalities in temporal visual processing, hypothesizing that palinopsia could arise from increased visibility of normal afterimage signals or prolonged visible persistence. Methods: Thirty controls and 31 participants with visual snow syndrome (18 with migraine) took part. Participants completed a palinopsia symptom questionnaire. Contrast detection thresholds were measured before and after brief exposure to a spatial grating because deficient contrast adaptation could increase afterimage visibility. Temporal integration and segregation were assessed using missing-element and odd-element tasks, respectively, because prolonged persistence would promote integration at wide temporal offsets. To distinguish the effects of visual snow syndrome from comorbid migraine, 25 people with migraine alone participated in an additional experiment. Results: Palinopsia was common in visual snow syndrome, typically presenting as unformed images that were frequently noticed. Contrary to our hypotheses, we found neither reduced contrast adaptation (F(3.22, 190.21) = 0.71, P = 0.56) nor significantly prolonged temporal integration thresholds (F(1, 59) = 2.35, P = 0.13) in visual snow syndrome. Instead, participants with visual snow syndrome could segregate stimuli in closer succession than controls (F(1, 59) = 4.62, P = 0.04, ηp2 = 0.073) regardless of co-occurring migraine (F(2, 53) = 1.22, P = 0.30). In contrast, individuals with migraine alone exhibited impaired integration (F(2, 53) = 4.44, P = 0.017, ηp2 = 0.14). Conclusions: Although neither deficient contrast adaptation nor prolonged visible persistence explains palinopsia, temporal resolution of spatial cues is enhanced and potentially more flexible in visual snow syndrome.
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Sensibilidad de Contraste , Fenotipo , Humanos , Femenino , Masculino , Adulto , Adulto Joven , Sensibilidad de Contraste/fisiología , Postimagen/fisiología , Trastornos de la Visión/fisiopatología , Persona de Mediana Edad , Síndrome , Umbral Sensorial/fisiología , Encuestas y Cuestionarios , Adolescente , Agudeza Visual/fisiología , Trastornos Migrañosos/fisiopatología , Trastornos Migrañosos/complicaciones , Trastornos de la PercepciónRESUMEN
Visual snow is a persistent visual disturbance in which small dots of light appear across the visual field of both eyes, like snowfall. The condition is not widely known, but an increasing number of cases have been described in the last 5 - 6 years. Many patients have consulted a number of specialists without receiving an explanation for their symptoms, and in this clinical review article we therefore wish to make the condition known to more clinicians.
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Trastornos de la Visión , Humanos , Trastornos de la Visión/etiología , Campos Visuales/fisiología , Trastornos de la PercepciónRESUMEN
BACKGROUND: To capture the distortion of exploratory activity typical of patients with spatial neglect, traditional diagnostic methods and new virtual reality applications use confined workspaces that limit patients' exploration behavior to a predefined area. Our aim was to overcome these limitations and enable the recording of patients' biased activity in real, unconfined space. METHODS: We developed the Free Exploration Test (FET) based on augmented reality technology. Using a live stream via the back camera on a tablet, patients search for a (non-existent) virtual target in their environment, while their exploration movements are recorded for 30 s. We tested 20 neglect patients and 20 healthy participants and compared the performance of the FET with traditional neglect tests. RESULTS: In contrast to controls, neglect patients exhibited a significant rightward bias in exploratory movements. The FET had a high discriminative power (area under the curve = 0.89) and correlated positively with traditional tests of spatial neglect (Letter Cancellation, Bells Test, Copying Task, Line Bisection). An optimal cut-off point of the averaged bias of exploratory activity was at 9.0° on the right; it distinguished neglect patients from controls with 85% sensitivity. DISCUSSION: FET offers time-efficient (execution time: â¼3 min), easy-to-apply, and gamified assessment of free exploratory activity. It supplements traditional neglect tests, providing unrestricted recording of exploration in the real, unconfined space surrounding the patient.
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Realidad Aumentada , Trastornos de la Percepción , Humanos , Masculino , Femenino , Trastornos de la Percepción/diagnóstico , Trastornos de la Percepción/fisiopatología , Trastornos de la Percepción/etiología , Persona de Mediana Edad , Anciano , Conducta Exploratoria/fisiología , Pruebas Neuropsicológicas/normas , Percepción Espacial/fisiología , AdultoAsunto(s)
Infarto de la Arteria Cerebral Media , Trastornos de la Percepción , Humanos , Trastornos de la Percepción/etiología , Infarto de la Arteria Cerebral Media/diagnóstico por imagen , Infarto de la Arteria Cerebral Media/complicaciones , Masculino , Persona de Mediana Edad , Anciano , FemeninoRESUMEN
This review aimed to assess the effect of repetitive transcranial magnetic stimulation (rTMS) in improving post-stroke unilateral spatial neglect (USN) using a meta-analysis. Further, we aimed to identify any association between rTMS parameters, patient demographics, and treatment effect sizes using subgroup analyses and meta-regression. A literature search was conducted through four databases from inception to March 6, 2024, to retrieve all relevant controlled trials investigating the effects of rTMS on symptoms of USN in post-stroke patients. Overall, rTMS significantly improved post-stroke USN, as measured by the line bisection test (Hedges' g = - 1.301, p < 0.0001), the cancelation test (Hedge's g = - 1.512, p < 0.0001), and the Catherine Bergego Scale (Hedges'g = - 0.770, p < 0.0001), compared to sham stimulation. Subgroup analysis found that generally larger effect sizes following excitatory rTMS across several outcome measures, indicating that excitatory rTMS on the ipsilesional hemisphere may be more effective than inhibitory rTMS on the contralesional hemisphere in ameliorating neglect symptoms. Meta-regression analysis of the line bisection test showed a significant difference in the chronicity of stroke patients, suggesting that rTMS may be more effective for USN in patients at the acute stage (within 3 months since stroke) than in those at the post-acute stage (p = 0.035). In conclusion, rTMS appears to be effective in promoting recovery from post-stroke USN. Excitatory protocols and early intervention may enhance recovery outcomes for neglect behaviors in post-stroke survivors.
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Trastornos de la Percepción , Accidente Cerebrovascular , Estimulación Magnética Transcraneal , Humanos , Evaluación de Resultado en la Atención de Salud , Trastornos de la Percepción/etiología , Trastornos de la Percepción/terapia , Trastornos de la Percepción/rehabilitación , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/terapia , Rehabilitación de Accidente Cerebrovascular/métodos , Estimulación Magnética Transcraneal/métodosRESUMEN
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 (ß=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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Trastornos de la Percepción , Recuperación de la Función , Accidente Cerebrovascular , Humanos , Trastornos de la Percepción/etiología , Trastornos de la Percepción/rehabilitación , Recuperación de la Función/fisiología , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/psicología , Rehabilitación de Accidente Cerebrovascular/métodosRESUMEN
Previous literature showed how left spatial neglect arises from an asymmetrical distribution of spatial attention. However, it was also suggested that left spatial neglect might be partially caused or at least worsened by non-spatial attention disorders of the right-lateralized stimulus-driven attentional fronto-parietal network. Here, we psychophysically tested the efficiency of temporal attentional engagement of foveal perception through meta-contrast (Experiment 1) and "attentional" masking (Experiment 2) tasks in patients with right-hemisphere stroke with left neglect (N+), without left neglect (N-) and matched healthy controls (C). In both experiments, N+ patients showed higher thresholds, not only than Cs, but also than N- patients. Temporal engagement was clinically impaired in all N+ patients and highly correlated with their typical inability to direct spatial attention towards stimuli on the left side. Our findings suggest that a temporal impairment of attentional engagement is a relevant deficit of left spatial neglect.
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Atención , Lateralidad Funcional , Trastornos de la Percepción , Percepción Espacial , Humanos , Trastornos de la Percepción/fisiopatología , Atención/fisiología , Masculino , Femenino , Persona de Mediana Edad , Anciano , Percepción Espacial/fisiología , Lateralidad Funcional/fisiología , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/psicología , Accidente Cerebrovascular/complicaciones , Pruebas Neuropsicológicas , Estimulación Luminosa/métodos , Percepción Visual/fisiologíaRESUMEN
Purpose: The purpose of this study was to investigate gaze-scanning by pedestrians with homonymous hemianopia (HH) when walking on mid-block sidewalks. Methods: Pedestrians with right homonymous hemianopia (RHH), and left homonymous hemianopia (LHH) without and with left spatial neglect (LHSN) walked on city streets wearing a gaze-tracking system. Gaze points were obtained by combining head movement and eye-in-head movement. Mixed-effects regression models were used to compare horizontal gaze scan magnitudes and rates between the side of the hemi-field loss (BlindSide) and the seeing side (SeeingSide), among the three subject groups, and between mid-block walking and street crossing segments. Results: A total of 7021 gaze scans were obtained from 341 minutes of mid-block walking videos by 19 participants (6 with LHH, 7 with RHH, and 6 with LHSN). The average gaze magnitude and scanning rate in mid-block segments were significantly higher towards the BlindSide than the SeeingSide in LHH (magnitude larger by 1.9° (degrees), P = 0.006; scan rate higher by 4.2 scans/minute, P < 0.001) and RHH subjects (magnitude larger by 3.3°, P < 0.001; scan rate higher by 3.2 scans/minute, P = 0.002), but they were not significantly different in LHSN subjects. The scanning rate, in terms of scans/minute (mean, 95% confidence interval [CI]) was significantly lower in LHSN subjects (mean = 6.9, 95% CI = 5.6-8.7) than LHH (mean = 10.2, 95% CI = 8.0-13.1; P = 0.03) and RHH (mean = 11.1, 95% CI = 9.0-13.7; P = 0.007) subjects. Compared to street-crossings, the scan rate during the mid-block segments was lower by 3.5 scans/minute (P < 0.001) and the gaze magnitude was smaller by 3.8° (P < 0.001) over the 3 groups. Conclusions: Evidence of compensatory scanning suggests a proactive, top-down mechanism driving gaze in HH. The presence of spatial neglect (SN) appeared to negatively impact the top-down process.
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Fijación Ocular , Hemianopsia , Peatones , Trastornos de la Percepción , Campos Visuales , Humanos , Hemianopsia/fisiopatología , Hemianopsia/diagnóstico , Masculino , Femenino , Anciano , Persona de Mediana Edad , Trastornos de la Percepción/fisiopatología , Trastornos de la Percepción/etiología , Campos Visuales/fisiología , Fijación Ocular/fisiología , Caminata/fisiología , Movimientos de la Cabeza/fisiología , Movimientos Oculares/fisiología , Adulto , Anciano de 80 o más Años , Tecnología de Seguimiento OcularRESUMEN
The primary symptom of visual snow syndrome (VSS) is the unremitting perception of small, flickering dots covering the visual field. VSS is a serious but poorly understood condition that can interfere with daily tasks. Several studies have provided qualitative data about the appearance of visual snow, but methods to quantify the symptom are lacking. Here, we developed a task in which participants with VSS adjusted parameters of simulated visual snow on a computer monitor until the simulation matched their internal visual snow. On each trial, participants (n = 31 with VSS) modified the size, density, update speed, and contrast of the simulation. Participants' settings were highly reliable across trials (intraclass correlation coefficients > 0.89), and they reported that the task was effective at stimulating their visual snow. On average, visual snow was very small (less than 2 arcmin in diameter), updated quickly (mean temporal frequency = 18.2 Hz), had low density (mean snow elements vs. background = 2.87%), and had low contrast (average root mean square contrast = 2.56%). Our task provided a quantitative assessment of visual snow percepts, which may help individuals with VSS communicate their experience to others, facilitate assessment of treatment efficacy, and further our understanding of the trajectory of symptoms, as well as the neural origins of VSS.
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Campos Visuales , Humanos , Adulto , Masculino , Femenino , Campos Visuales/fisiología , Adulto Joven , Estimulación Luminosa/métodos , Persona de Mediana Edad , Sensibilidad de Contraste/fisiología , Trastornos de la Percepción/fisiopatología , Trastornos de la Percepción/etiología , Percepción Visual/fisiología , Simulación por Computador , Trastornos de la Visión/fisiopatologíaRESUMEN
Unilateral spatial neglect is the failure of brain-damaged patients to report, respond, or orient to novel or meaningful stimuli presented to the contralateral side of the lesion. This usually involves the right cerebral hemisphere. Neglect presents with no restriction in gaze direction and results in difficulty across various aspects of daily activities, distinguishing it from simple homonymous hemianopia. The basic mechanisms underlying neglect is rightward bias of spatial attention, while non-direction-specific cognitive problems may contribute to clinical expressions of neglect.
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Trastornos de la Percepción , Humanos , Trastornos de la Percepción/fisiopatología , Trastornos de la Percepción/etiología , Percepción Espacial/fisiología , Atención/fisiología , Lateralidad Funcional/fisiologíaRESUMEN
Unilateral spatial neglect (USN) is a symptom of unilateral brain damage resulting in failure to report sensory phenomena in the contra-lesional space. It is associated with motor impairment as well as sensory deficits. Recent research suggests that USN, may be caused by a disruption in the interhemispheric balance of the visual attention network. Based on this hypothesis, non-invasive brain stimulation (NIBS), such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), is utilized in the rehabilitation of USN patients. Presently, inhibitory stimulation by continuous theta burst stimulation (cTBS) on contra-lesional parietal cortex are believed to be the most promising method. Conversely, compensation by attentional network of the non-lesioned hemisphere plays an important role in the recovery of USN. Recent imaging studies revealed that functional and structural connectivity of attentional networks within a lesioned hemisphere and between lesioned and non-lesioned hemispheres affects spontaneous recovery and effectiveness of rehabilitation approach such as prism adaptation therapy. These findings are useful in elucidating the pathophysiology of USN and predicting functional outcome. Furthermore, we hope that understanding the pathophysiology will enable the development of new rehabilitation strategies and appropriate treatment selection.
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Trastornos de la Percepción , Estimulación Magnética Transcraneal , Humanos , Trastornos de la Percepción/rehabilitación , Trastornos de la Percepción/fisiopatología , Trastornos de la Percepción/terapia , Trastornos de la Percepción/etiología , Estimulación Transcraneal de Corriente Directa , Atención/fisiologíaRESUMEN
An influential model of spatial attention postulates three main attention-orienting mechanisms: disengagement, shifting, and engagement. Early research linked disengagement deficits with superior parietal damage, regardless of hemisphere or presence of spatial neglect. Subsequent studies supported the involvement of more ventral parietal regions, especially in the right hemisphere, and linked spatial neglect to deficient disengagement from ipsilateral cues. However, previous lesion studies faced serious limitations, such as small sample sizes and the lack of brain-injured controls without neglect. Additionally, some studies employed symbolic cues or used long cue-target intervals, which may fail to reveal impaired disengagement. We here used a machine-learning approach to conduct lesion-symptom mapping (LSM) on 89 patients with focal cerebral lesions to the left (LH) or right (RH) cerebral hemisphere. A group of 54 healthy participants served as controls. The paradigm used to uncover disengagement deficits employed non-predictive cues presented in the visual periphery and at short cue-target intervals, targeting exogenous attention. The main factors of interest were group (healthy participants, LH, RH), target position (left, right hemifield) and cue validity (valid, invalid). LSM-analyses were performed on two indices: the validity effect, computed as the absolute difference between reaction times (RTs) following invalid compared to valid cues, and the disengagement deficit, determined by the difference between contralesional and ipsilesional validity effects. While LH patients showed general slowing of RTs to contralesional targets, only RH patients exhibited a disengagement deficit from ipsilesional cues. LSM associated the validity effect with a right lateral frontal cluster, which additionally affected subcortical white matter of the right arcuate fasciculus, the corticothalamic pathway, and the superior longitudinal fasciculus. In contrast, the disengagement deficit was related to damage involving the right temporoparietal junction. Thus, our results support the crucial role of right inferior parietal and posterior temporal regions for attentional disengagement, but also emphasize the importance of lateral frontal regions, for the reorienting of attention.
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Atención , Lóbulo Frontal , Lateralidad Funcional , Lóbulo Parietal , Tiempo de Reacción , Humanos , Masculino , Femenino , Persona de Mediana Edad , Lóbulo Parietal/fisiopatología , Atención/fisiología , Anciano , Lateralidad Funcional/fisiología , Adulto , Tiempo de Reacción/fisiología , Lóbulo Frontal/fisiopatología , Trastornos de la Percepción/etiología , Trastornos de la Percepción/fisiopatología , Señales (Psicología) , Percepción Espacial/fisiología , Lesiones Encefálicas/fisiopatologíaRESUMEN
Cerebral small vessel disease (CSVD) impairs visuospatial function, and this is one of the most obvious areas of cognitive impairment in CSVD. So, recognizing, monitoring, and treating visuospatial dysfunction are all important to the prognosis of CSVD. This review discussed the anatomical and pathological mechanisms, clinical recognition (scales, imaging, and biomarkers), and treatment of cognitive impairment especially visuospatial dysfunction in CSVD.
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Enfermedades de los Pequeños Vasos Cerebrales , Humanos , Enfermedades de los Pequeños Vasos Cerebrales/complicaciones , Enfermedades de los Pequeños Vasos Cerebrales/fisiopatología , Disfunción Cognitiva/fisiopatología , Disfunción Cognitiva/etiología , Percepción Espacial/fisiología , Trastornos de la Percepción/fisiopatología , Trastornos de la Percepción/etiología , Percepción Visual/fisiologíaRESUMEN
In the absence of any complaints in early childhood, preterm children remain more at risk of encountering academic difficulties, but their clinical picture remains not well characterized. We screened visuospatial perception in 70 children born preterm consulting for scholar complaints. Developmental Coordination Disorder (with or without comorbidities) was associated with high prevalence (27%) of impaired perception of spatial relationship. Prematurely born children who obtained no diagnosis of Neuro-Developmental Disorder exhibited a high prevalence (31%) of impaired perception of object magnitude. Regression revealed that low gestational age and fetal growth restriction significantly predicted the magnitude but not the spatial relationship perception.
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Recien Nacido Prematuro , Percepción Espacial , Humanos , Femenino , Masculino , Percepción Espacial/fisiología , Niño , Trastornos de la Percepción/etiología , Trastornos de la Percepción/fisiopatología , Preescolar , Percepción Visual/fisiología , Recién Nacido , Parálisis Cerebral/fisiopatología , Retardo del Crecimiento Fetal/fisiopatología , Edad GestacionalRESUMEN
INTRODUCTION: Patients who have suffered a stroke may present with visuospatial neglect (VSN). In clinical practice, different degrees of impairment can be observed among patients with VSN; however, there is no consensus regarding the criteria and tests used to determine them. AIM: This study aims to classify patients with VSH based on their level of impairment and to study their response to computerized cognitive training. PATIENTS AND METHODS: The sample consisted of 34 patients (19 men and 15 women) with a mean age of 47.59 ± 8.39 years. All patients underwent a neuropsychological exploration protocol composed of specific tests that assess visuospatial attention and others to evaluate multiple cognitive domains. All participants underwent computerized cognitive training consisting of 15 one-hour sessions. RESULTS: A cluster analysis was performed that divided the sample into three groups: group 1: mildly affected VSN (n = 17), group 2: moderately affected VSN (n = 11), and group 3: severely affected VSN (n = 6). Statistically significant differences were found in all tests of the visuospatial attention protocol, both in the pre-treatment and post-treatment evaluation. CONCLUSIONS: There are different levels of impairment among patients with VSN, differences that persist after applying computerized cognitive training. These results suggest that the evolution of VSN follows a homogeneous pattern linked to the initial level of impairment. These findings, although preliminary, may be relevant to neurorehabilitation professionals.
TITLE: Variabilidad interindividual en pacientes con heminegligencia visuoespacial: estudio retrospectivo.Introducción. Los pacientes que han sufrido un ictus pueden presentar heminegligencia visuoespacial (HVE). En la práctica clínica es posible observar diferentes grados de afectación entre los pacientes con HVE; sin embargo, no existe consenso respecto a los criterios y pruebas utilizadas para determinarlos. Objetivo. Este estudio tiene como objetivo clasificar a los pacientes que presentan HVE en función de su nivel de afectación y estudiar su respuesta a un entrenamiento cognitivo computarizado. Pacientes y métodos. La muestra estaba formada por 34 pacientes (19 hombres y 15 mujeres) con una edad media de 47,59 ± 8,39 años. A todos los pacientes se les administró un protocolo de exploración neuropsicológico compuesto por pruebas específicas que evalúan la atención visuoespacial y otro para evaluar múltiples dominios cognitivos. Todos los participantes realizaron un entrenamiento cognitivo computarizado consistente en 15 sesiones de una hora de duración. Resultados. Se realizó un análisis de conglomerados que dividió la muestra en tres grupos: grupo 1, HVE con afectación leve (n = 17); grupo 2, HVE con afectación moderada (n = 11); y grupo 3, HVE con afectación grave (n = 6). Se obtuvieron diferencias estadísticamente significativas en todas las pruebas del protocolo de atención visuoespacial, tanto en la evaluación pretratamiento como en la postratamiento. Conclusiones. Existen diferentes niveles de afectación entre los pacientes con HVE, diferencias que se mantienen después de aplicar un entrenamiento cognitivo computarizado. Estos resultados sugieren que la evolución de la HVE sigue un patrón homogéneo vinculado al nivel de afectación inicial. Estos hallazgos, aunque preliminares, pueden ser relevantes para los profesionales de la neurorrehabilitación.
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Trastornos de la Percepción , Humanos , Trastornos de la Percepción/etiología , Femenino , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto , Pruebas Neuropsicológicas , AncianoRESUMEN
PURPOSE: To explore efficacy of the "Rey-Osterrieth complex figure (ROCF) tracing task" as a new test to detect unilateral spatial neglect (USN). METHODS: Subjects were 40 healthy control (HC) and 20 right brain-damaged patients with (USN + , n = 10) or without USN (USN - , n = 10). After the ROCF copying task, the tracing task was performed under conditions that did not leave any tracing lines on the sample figure. Evaluation used the conventional 36-point scoring system, laterality index (LI) as the ratio of the left and right structure scores, and the number of overlaps for each of the left and right structures scored. RESULTS: In the tracing task, USN + showed a lower LI than HC. Furthermore, left-sided neglect was sometimes more evident than in the copying task. Regarding the total overlapping score, USN + showed a greater score than HC. The right-sided overlapping scores in USN + and USN - were also greater than that in HC. In the right brain-damaged subjects, clinically meaningful correlations were not found between evaluations in the ROCF tracing task and in conventional USN screening tests. Receiver-operating-characteristic analysis to test the power of detection showed moderate performance for the tracing LI (AUC = 0.76, 95% CI = 0.54-0.97), which was greater than that of other tests. Further, the total overlapping score in the tracing task showed sensitivity 0.9 (highest among the tests performed), specificity 0.5, and AUC 0.68 (95% CI = 0.43-0.92). CONCLUSION: The ROCF tracing task might be a convenient method to detect USN and to reveal the extent of spatial working memory impairment.
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Lateralidad Funcional , Pruebas Neuropsicológicas , Trastornos de la Percepción , Humanos , Trastornos de la Percepción/diagnóstico , Trastornos de la Percepción/fisiopatología , Masculino , Femenino , Proyectos Piloto , Anciano , Lateralidad Funcional/fisiología , Persona de Mediana Edad , Pruebas Neuropsicológicas/normas , Percepción Espacial/fisiología , Anciano de 80 o más AñosRESUMEN
OBJECTIVE: To investigate the effects of a stimulus response task using virtual reality (VR) for unilateral spatial neglect (USN). DESIGN: Double-blind randomized controlled trial. SETTING: Acute phase hospital where stroke patients are hospitalized. PARTICIPANTS: The participants were 42 patients (N=42) with right-hemisphere cerebral damage who had been experiencing USN in their daily lives. They were randomly assigned to 3 groups: a stimulus response task with a background shift (SR+BS group), a stimulus response task without a background shift (SR group), and an object gazing task (control group). INTERVENTIONS: The stimulus response task was to search for balloons that suddenly appeared on the VR screen. A background shift was added to highlight the search in the neglected space. The control task was to maintain a controlled gaze on a balloon that appeared on the VR screen. The intervention period was 5 days. MAIN OUTCOME MEASURES: The primary outcome was the participants' scores on a stimulus-driven attention test (SAT) using the reaction time. The stimuli of the SAT were divided into 6 blocks of 3 lines on each side (-3 to +3). The secondary outcomes were their scores on the Behavioral Intention Test conventional, Catherine Bergego Scale, and straight ahead pointing tests. RESULTS: In the SAT, there were significant interaction effects of reaction time between time and group factors in left-2, right+2, and right+3. The SR+BS and SR groups showed significant improvements in the reaction time of left-2 and right+3 compared with the control group. Moreover, the SR+BS group showed a significant improvement in the reaction time of left-2, which was the neglected space, compared with the SR group. However, there were no significant interaction effects of Behavioral Intention Test conventional, Catherine Bergego Scale, and straight ahead pointing. CONCLUSIONS: Our results suggest that the use of stimulus response tasks using VR combined with background shifts may improve left-sided USN.