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1.
Medicine (Baltimore) ; 100(9): e24781, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655943

RESUMO

BACKGROUND: Even though a variety of rehabilitative technique have been implemented to ameliorate neglect symptoms of patients with stoke, the effects of limb activation using a robotic device are still unknown. The purpose of this study was to investigate the effects of the robot-assisted hand training on hemispatial neglect of older patients with chronic stroke. METHODS: The participants were randomly allocated to the experimental group (EG) receiving robot-assisted left-hand training (n = 12) or the control group (CG) receiving conventional treatments for neglect symptoms (n = 12). All participants received 20 sessions for 4-week. To examine the effects on hemispatial neglect, the line bisection test (LBT), the Albert test, and the Catherine Bergego Scale (CBS) were utilized. The outcome measures were analyzed before and after the 20 training sessions. RESULTS: After the intervention, improvements in the LBT, the Albert test, and the CBS were found in the EG whereas there were significant improvements in the LBT and the CBS but not the Albert test in the CG. In addition, the EG showed a significantly greater gain in all outcome measures compared to the CG (p < .05). CONCLUSIONS: These results indicate that robot-assisted hand training was beneficial to improving the hemispatial neglect of elderly person with chronic stroke compared to the conventional treatments. Robot-assisted limb activation might be useful to ameliorate hemispatial neglect of the elderly with chronic stroke.


Assuntos
Transtornos da Percepção/reabilitação , Robótica/métodos , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/complicações , Idoso , Doença Crônica , Feminino , Lateralidade Funcional/fisiologia , Mãos/fisiopatologia , Humanos , Masculino , Transtornos da Percepção/etiologia , Transtornos da Percepção/fisiopatologia , Projetos Piloto , Acidente Vascular Cerebral/fisiopatologia , Resultado do Tratamento
2.
Am J Phys Med Rehabil ; 100(3): 259-265, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33595938

RESUMO

OBJECTIVE: The aim of this study was to investigate the effects of prism adaptation (PA) on unilateral neglect after stroke. METHODS: Randomized clinical trials, published up to January 31, 2020, comparing PA with neutral goggles or no goggles were systematically searched and included. Two independent reviewers performed data extraction and assessed the quality of studies using the Physiotherapy Evidence Database scale. RESULTS: A total of seven randomized trials, involving 211 participants, satisfied the inclusion criteria. There was no significant immediate benefit of PA as measured by Behavioral Inattention Test (BIT) (weighted mean difference [WMD], 5.10; [95% confidence interval (CI), -6.68 to 16.88]), behavioral subset (BIT-B; WMD, 3.40 [95% CI, -3.97 to 10.76), conventional subset (BIT-C; WMD, 9.98 [95% CI, -0.42 to 20.38]), and Catherine Bergego Scale (WMD, -0.52 [95% CI, -1.98 to 0.93]). No statistical difference was observed between PA and control on the long-term effect (BIT: WMD, 1.92 [95% CI, -9.34 to 13.18]; BIT-B: WMD, -3.28 [95% CI, -11.89 to 5.34]; BIT-C: WMD, 2.66 [95% CI, -10.35 to 11.67]; Catherine Bergego Scale: WMD, -1.22 [95% CI, -3.05 to 0.62]). CONCLUSIONS: PA did not show a greater improvement on neglect symptoms in post-stroke patients with unilateral neglect, compared with placebo or no treatment. These findings do not support the routine use of PA in patients with unilateral neglect after stroke.


Assuntos
Transtornos da Percepção/fisiopatologia , Transtornos da Percepção/reabilitação , Reabilitação do Acidente Vascular Cerebral/métodos , Adaptação Fisiológica , Óculos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
BMJ Case Rep ; 14(1)2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504525

RESUMO

Upside-down reversal of vision (UDRV) is a rare form of metamorphopsia, or visual illusions that can distort the size, shape or inclination of objects. This phenomenon is paroxysmal and transient in nature, with patients reporting a sudden inversion of vision in the coronal plane, which typically remains for seconds or minutes, though occasionally persists for hours or days, before returning to normal. Distorted egocentric orientation (ie, the patient perceives the body to be tilted away from the vertical plane) is even more rare as a co-occurring phenomenon. To the best of our knowledge, this is the first reported case of a veteran who presented with UDRV and distorted egocentric orientation during hospitalisation on an inpatient physical medicine and rehabilitation setting following an elective hip surgery. This case serves not only to document the presence of rare visual illusions, but also illustrates the importance and value of an interdisciplinary team approach.


Assuntos
Doença de Graves/diagnóstico , Ilusões , Transtornos da Percepção/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Veteranos , Transtornos da Visão/diagnóstico , Idoso , Antitireóideos/uso terapêutico , Artroplastia de Quadril , Moldes Cirúrgicos , Endocrinologia , Doença de Graves/tratamento farmacológico , Luxação do Quadril/cirurgia , Hospitais de Veteranos , Humanos , Masculino , Metimazol/uso terapêutico , Neuropsicologia , Equipe de Assistência ao Paciente , Transtornos da Percepção/fisiopatologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/cirurgia , Psiquiatria , Reoperação , Transtornos da Visão/fisiopatologia
4.
PLoS One ; 15(6): e0234382, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584824

RESUMO

A brief session of rightward prismatic adaptation (R-PA) has been shown to alleviate neglect symptoms in patients with right hemispheric damage, very likely by switching hemispheric dominance of the ventral attentional network (VAN) from the right to the left and by changing task-related activity within the dorsal attentional network (DAN). We have investigated this very rapid change in functional organisation with a network approach by comparing resting-state connectivity before and after a brief exposure i) to R-PA (14 normal subjects; experimental condition) or ii) to plain glasses (12 normal subjects; control condition). A whole brain analysis (comprising 129 regions of interest) highlighted R-PA-induced changes within a bilateral, fronto-temporal network, which consisted of 13 nodes and 11 edges; all edges involved one of 4 frontal nodes, which were part of VAN. The analysis of network characteristics within VAN and DAN revealed a R-PA-induced decrease in connectivity strength between nodes and a decrease in local efficiency within VAN but not within DAN. These results indicate that the resting-state connectivity configuration of VAN is modulated by R-PA, possibly by decreasing its modularity.


Assuntos
Atenção/fisiologia , Encéfalo/fisiologia , Rede Nervosa/fisiologia , Adaptação Fisiológica , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Lesões Encefálicas/diagnóstico por imagem , Lesões Encefálicas/fisiopatologia , Lesões Encefálicas/terapia , Estudos de Casos e Controles , Conectoma , Óculos , Feminino , Lateralidade Funcional/fisiologia , Neuroimagem Funcional , Humanos , Imagem por Ressonância Magnética , Masculino , Rede Nervosa/diagnóstico por imagem , Rede Nervosa/fisiopatologia , Dispositivos Ópticos , Transtornos da Percepção/diagnóstico por imagem , Transtornos da Percepção/fisiopatologia , Transtornos da Percepção/terapia , Adulto Jovem
5.
J Rehabil Med ; 52(6): jrm00072, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32488286

RESUMO

OBJECTIVE: To examine the clinical and functional characteristics associated with contralateral spatial neglect in right compared with left subacute stroke, and to investigate the correlations between neglect severity and stroke severity, functional ability and outcome. METHODS: Cross-sectional study comparing neurological impairment and disability. The same data-set was used in part 2 of this study. RESULTS: Contralateral neglect was present in 79.7% of right stroke and 68.3% of left stroke rehabilitants, and was, on average, equally mild. Left stroke rehabilitants with neglect had higher stroke severity, cognitive and total disability and dependence level and more impaired sphincter control than right stroke rehabilitants with neglect, while the occurrence of depression, motor and sensory impairment was similar. Rehabilitants with neglect, irrespective of stroke side, had higher stroke severity, cognitive, motor and total disability and dependence level than rehabilitants without neglect. CONCLUSION: In left and right stroke rehabilitants with equally mild neglect, those with left stroke had higher stroke severity, cognitive and total disability and dependence level. Neglect severity correlated with right or left stroke severity and functional ability, moderate to severe neglect correlated significantly more with functioning. Neglect severity was independently associated with functional outcome in right stroke.


Assuntos
Lateralidade Funcional/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Percepção/complicações , Transtornos da Percepção/fisiopatologia , Resultado do Tratamento
6.
Invest Ophthalmol Vis Sci ; 61(5): 24, 2020 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-32416605

RESUMO

Purpose: The axial separation between the iris and the intraocular lens (IOL) in pseudophakic eyes can cause rays originating from the far temporal field to miss the IOL, resulting in negative dysphotopsia (ND). We developed an experimental model to test the hypothesis that obstruction of rays from the far temporal field can generate ND and an accompanying loss of visual sensitivity in the far temporal field. Methods: The right eyes of 10 phakic subjects were fitted with soft contact lenses containing a 5.50-mm central clear zone and a 12-mm outer diameter opaque annulus. In three of the subjects, eyes were dilated with 1% tropicamide solution, and effective aperture diameters were determined optically (pupil camera) and psychophysically (narrow beam detection). Visual field extent (Goldmann bowl) and temporal and inferotemporal meridian sensitivities (Octopus perimeter) were measured. A wide-angle model was constructed to quantify the impact of the annular opacity on retinal illuminance. Results: All 10 subjects observed a dark crescent in the far temporal and inferotemporal fields. The opaque annulus reduced effective horizontal pupil diameters from 8 mm to 5.5 mm on-axis and from >2 mm to <1 mm at 90°. Perimetry revealed a 10° reduction in temporal and inferotemporal field extent and increasing loss of sensitivity beyond 70°. The wide-angle model confirmed significant vignetting (>50% beyond 70°), approaching zero retinal illuminance beyond 85°. Conclusions: Vignetting of rays originating from the far temporal field by axially separated apertures can create symptoms mirroring perceptual reports of negative dysphotopsia in symptomatic pseudophakic patients.


Assuntos
Cristalino/fisiologia , Modelos Teóricos , Transtornos da Percepção/fisiopatologia , Transtornos da Visão/fisiopatologia , Campos Visuais/fisiologia , Adulto , Lentes de Contato Hidrofílicas , Feminino , Humanos , Luz , Masculino , Pessoa de Meia-Idade , Midriáticos/administração & dosagem , Ajuste de Prótese , Pupila/efeitos dos fármacos , Retina/efeitos da radiação , Tropicamida/administração & dosagem , Testes de Campo Visual , Adulto Jovem
7.
J Clin Neurosci ; 76: 243-245, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32284291

RESUMO

Alice in wonderland syndrome (AIWS) is a rare perceptual disorder characterized by subjective distortions of visual and somatosensory perception. Symptoms of AIWS are attributable to functional and structural changes of the visual and somatosensory perceptual system; however, few reports have investigated the pathophysiology of AIWS with regard to epilepsy, especially ictal electroencephalogram (EEG) changes. Herein, we describe the case of an 82-year-old woman with focal onset epilepsy presenting with AIWS, whose seizures were documented by video-EEG monitoring. Video-EEG revealed multiple focal impaired awareness seizures, and ictal EEG changes arose from the right occipital region with small periodic positive discharges with evolution towards the right centro-parietal regions. Our case highlights not only a relationship between epileptic seizures and AIWS but also provides pathological insight into AIWS.


Assuntos
Síndrome de Alice no País das Maravilhas/fisiopatologia , Epilepsias Parciais/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Eletroencefalografia , Feminino , Humanos , Lobo Occipital/fisiopatologia , Lobo Parietal/fisiopatologia , Transtornos da Percepção/fisiopatologia , Convulsões/fisiopatologia
8.
NeuroRehabilitation ; 46(3): 423-431, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32250335

RESUMO

BACKGROUND: Several studies on carpal tunnel syndrome have reported pain that exists beyond the median nerve territory of the affected hand. However, the mechanism is unknown. PURPOSE: We investigated the cause of extra-territorial pain by the analysis of clinical assessments and cortical activity using magnetoencephalography. METHODS: To compare patients with and without extra-territorial pain, fourteen patients with carpal tunnel syndrome were assessed using clinical examination, such as patients' profile, paresthesia, physical tests, and psychological tests. The physical assessment included tactile threshold and static and moving two-point discrimination sensations on digital pulp. Neural activation in the cerebral cortex was also measured using z-scores calculated by magnetoencephalography. RESULTS: Among fourteen patients, ten patients had pain in the affected median nerve territory only and four patients had extra-territorial pain. When comparing the groups, the static and moving two-point discrimination sensation values in patients with extra-territorial pain were larger than those of patients without the pain (p < 0.05). The supra-marginal gyrus, mid-part of the precentral sulcus, angular gyrus in the left hemisphere, bilateral sensorimotor areas for legs, and bilateral isthmus-cingulate areas showed larger z-scores in patients with extra-territorial pain than in patients without the pain (p < 0.05). CONCLUSIONS: The static and moving two-point discrimination sensations signify the ability of tactile spatial acuity. Bilateral sensorimotor areas were activated in sites that were not the hand. Furthermore, the inferior parietal lobule in the left hemisphere, which synthesizes and integrates multiple sensations showed high activation. Our findings suggested that the mechanism of extra-territorial pain was associated with dysfunction of spatial cognition.


Assuntos
Síndrome do Túnel Carpal/fisiopatologia , Dor Referida/fisiopatologia , Idoso , Feminino , Dedos/fisiopatologia , Humanos , Magnetoencefalografia , Masculino , Nervo Mediano/fisiopatologia , Pessoa de Meia-Idade , Transtornos da Percepção/fisiopatologia
9.
J Vis Exp ; (156)2020 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-32116302

RESUMO

Hemispatial neglect is a common impairment after stroke. It is associated with poor functional and social outcomes. Therefore, an adequate intervention is imperative for the successful management of hemispatial neglect. However, the clinical use of various interventions is limited in real clinical practice. Prism adaptation therapy is one of the most evidence-based rehabilitation modalities to treat hemispatial neglect. To overcome any possible shortcoming that may occur with prism therapy, we developed a new system using immersive virtual reality and depth-sensing camera to create a virtual prism adaptation therapy (VPAT). To validate the VPAT system, we designed an experimental protocol investigating the behavioral errors and changes in cortical activation via the VPAT system. Cortical activation was measured by functional near infrared spectroscopy (fNIRS). The experiment consisted of four phases. All four included clicking, pointing or rest applied to right-handed healthy people. Clicking versus pointing was used for investigating the cortical region related with the gross motor task, and pointing with VPAT versus pointing without VPAT was used for investigating the cortical region associated with visuospatial perception. The preliminary results from four healthy participants showed that pointing errors by the VPAT system was similar to the conventional prism adaptation therapy. Further analysis with more participants and fNIRS data, as well as a study in patients with stroke may be required.


Assuntos
Transtornos da Percepção/reabilitação , Acidente Vascular Cerebral/terapia , Adaptação Fisiológica/fisiologia , Adulto , Feminino , Humanos , Masculino , Transtornos da Percepção/fisiopatologia , Espectroscopia de Luz Próxima ao Infravermelho , Interface Usuário-Computador , Realidade Virtual
10.
Cogn Behav Neurol ; 33(1): 63-66, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32132404

RESUMO

Individuals with a hemispheric infarction often reveal inattention to, or neglect of, contralesional lateral space (ie, hemispatial neglect). Individuals with a bilateral ventral temporal-occipital lesion have been shown to demonstrate upper vertical neglect, and those with a bilateral parietal-occipital lesion have been shown to demonstrate lower vertical neglect. However, to our knowledge, there have been no reports of individuals with vertical neglect from a unilateral hemispheric lesion. We report on a 72-year-old, right-handed male who developed transient left hemiparesis. On examination, he had left facial weakness and he bisected horizontal lines to the left of the midline (ie, ipsilesional neglect). In addition, on a line bisection test involving nine vertical line bisections, he demonstrated downward deviation in the majority of the trials; healthy individuals deviate upward. On brain imaging, our patient revealed a cerebral infarction, primarily affecting the right temporal lobe; the temporal lobes contain the ventral attentional network that allocates attention upward. There is also some evidence that, whereas the right hemisphere mediates attention upward, the left mediates attention downward. Therefore, injury to the right temporal lobe may account for our patient's upward neglect with downward deviation. However, further studies are needed to better understand the pathophysiology of vertical neglect.


Assuntos
Encéfalo/patologia , Lateralidade Funcional/fisiologia , Transtornos da Percepção/fisiopatologia , Acidente Vascular Cerebral/complicações , Lobo Temporal/patologia , Idoso , Humanos , Masculino , Acidente Vascular Cerebral/patologia
11.
Invest Ophthalmol Vis Sci ; 61(3): 22, 2020 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-32181800

RESUMO

Purpose: To assess interocular delays in amblyopes with stereopsis and to evaluate the relationship between interocular delays and the clinical characteristics. Methods: Twenty amblyopes with stereopsis (median, 400 arcseconds) and 20 controls with normal or corrected to normal visual acuity (≤0 logMAR) and normal stereopsis (≤60 arcseconds) participated. Using a rotating cylinder defined by horizontally moving Gabor patches, we produced a spontaneous Pulfrich phenomenon in order to determine the interocular delays, that is, the interocular phase difference at which ambiguous motion in plane was perceived. Two spatial frequencies-a low (0.95 cycles/degree [c/d]) and a medium (2.85 c/d) spatial frequency-were tested. Results: The absolute interocular delays of the amblyopic group was significantly longer than that of the controls at both low or medium spatial frequencies (P < 0.01). However, the interocular delays was not always in favor of the fellow eye: 35% of the amblyopes (7/20) showed a faster processing of the amblyopic eye than that of the fellow eye at 0.95 c/d and 29.5% (5/17) at 2.85 c/d. No significant correlation was found between interocular delays and the clinical characteristics (e.g., age, treatment history, stereoacuity, and magnitude of anisometropia) in this amblyopic cohort. Conclusions: The interocular delays in amblyopes with stereopsis might result from either a faster or slower processing of the amblyopic eye relative to the fellow eye. This work provides important additional information for binocular processing of dynamic visual stimuli in amblyopia. However, the special role between this form of interocular delays and patients' clinical characteristics remains unknown.


Assuntos
Ambliopia/fisiopatologia , Percepção de Profundidade/fisiologia , Percepção de Movimento/fisiologia , Transtornos da Percepção/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Limiar Sensorial , Visão Binocular/fisiologia , Acuidade Visual/fisiologia , Adulto Jovem
12.
J Neurosci ; 40(11): 2259-2268, 2020 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-32024780

RESUMO

Frequency discrimination learning is often accompanied by an expansion of the functional region corresponding to the target frequency within the auditory cortex. Although the perceptual significance of this plastic functional reorganization remains debated, greater cortical representation is generally thought to improve perception for a stimulus. Recently, the ability to expand functional representations through passive sound experience has been demonstrated in adult rats, suggesting that it may be possible to design passive sound exposures to enhance specific perceptual abilities in adulthood. To test this hypothesis, we exposed adult female Long-Evans rats to 2 weeks of moderate-intensity broadband white noise followed by 1 week of 7 kHz tone pips, a paradigm that results in the functional over-representation of 7 kHz within the adult tonotopic map. We then tested the ability of exposed rats to identify 7 kHz among distractor tones on an adaptive tone discrimination task. Contrary to our expectations, we found that map expansion impaired frequency discrimination and delayed perceptual learning. Rats exposed to noise followed by 15 kHz tone pips were not impaired at the same task. Exposed rats also exhibited changes in auditory cortical responses consistent with reduced discriminability of the exposure tone. Encouragingly, these deficits were completely recovered with training. Our results provide strong evidence that map expansion alone does not imply improved perception. Rather, plastic changes in frequency representation induced by bottom-up processes can worsen perceptual faculties, but because of the very nature of plasticity these changes are inherently reversible.SIGNIFICANCE STATEMENT The potent ability of our acoustic environment to shape cortical sensory representations throughout life has led to a growing interest in harnessing both passive sound experience and operant perceptual learning to enhance mature cortical function. We use sound exposure to induce targeted expansions in the adult rat tonotopic map and find that these bottom-up changes unexpectedly impair performance on an adaptive tone discrimination task. Encouragingly, however, we also show that training promotes the recovery of electrophysiological measures of reduced neural discriminability following sound exposure. These results provide support for future neuroplasticity-based treatments that take into account both the sensory statistics of our external environment and perceptual training strategies to improve learning and memory in the adult auditory system.


Assuntos
Estimulação Acústica/efeitos adversos , Córtex Auditivo/fisiologia , Transtornos da Percepção/etiologia , Nível de Discriminação Sonora/fisiologia , Animais , Mapeamento Encefálico/métodos , Condicionamento Operante/fisiologia , Feminino , Plasticidade Neuronal , Ruído , Transtornos da Percepção/fisiopatologia , Transtornos da Percepção/reabilitação , Ratos , Ratos Long-Evans , Recompensa
14.
Trials ; 21(1): 44, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31915035

RESUMO

BACKGROUND: An increasing number of children are suffering from brain damage-related visual processing dysfunctions (VPD). There is currently a lack of evidence-based intervention methods that can be used early in development. We developed a visual intervention protocol suitable from 1 year of age. The protocol is structured, comprehensive and individually adaptive, and is paired with quantitative outcome assessments. Our aim is to investigate the effectiveness of this first visual intervention program for young children with (a risk of) VPD. METHODS: This is a single-blind, placebo-controlled trial that is embedded within standard clinical care. The study population consists of 100 children born very or extremely preterm (< 30 weeks) at 1 year of corrected age (CA), of whom 50% are expected to have VPD. First, children undergo a visual screening at 1 year CA. If they are classified as being at risk of VPD, they are referred to standard care, which involves an ophthalmic and visual function assessment and a (newly developed) visual intervention program. This program consists of a general protocol (standardized and similar for all children) and a supplement protocol (adapted to the specific needs of the child). Children are randomly allocated to an intervention group (starting upon inclusion at 1 year CA) or a control group (postponed: starting at 2 years CA). The control group will receive a placebo treatment. The effectiveness of early visual intervention will be examined with follow-up visual and neurocognitive assessments after 1 year (upon completion of the direct intervention) and after 2 years (upon completion of the postponed intervention). DISCUSSION: Through this randomized controlled trial we will establish the effectiveness of a new and early visual intervention program. Combining a general and supplement protocol enables both structured comparisons between participants and groups, and custom habilitation that is tailored to a child's specific needs. The design ensures that all included children will benefit from participation by advancing the age at which they start receiving an intervention. We expect results to be applicable to the overall population of children with (a risk of) VPD early in life. TRIAL REGISTRATION: Netherlands Trial Register: NTR6952. Registered 19 January 2018.


Assuntos
Transtornos do Neurodesenvolvimento/complicações , Transtornos da Percepção/prevenção & controle , Nascimento Prematuro/fisiopatologia , Transtornos da Visão/prevenção & controle , Percepção Visual/fisiologia , Encéfalo/fisiopatologia , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Cognição , Feminino , Seguimentos , Humanos , Lactente , Masculino , Países Baixos , Transtornos do Neurodesenvolvimento/fisiopatologia , Transtornos da Percepção/diagnóstico , Transtornos da Percepção/etiologia , Transtornos da Percepção/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Fatores de Tempo , Tempo para o Tratamento , Resultado do Tratamento , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Transtornos da Visão/fisiopatologia
15.
Neuropsychologia ; 138: 107356, 2020 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-31972231

RESUMO

Focal brain lesions may induce dysfunctions in distant brain regions leading to behavioral impairments. Based on this concept of 'diaschisis', spatial neglect following stroke has been related to structural damage of the right-lateralized ventral attention network (VAN) and disrupted inter-hemispheric functional connectivity (FC) in the bilateral dorsal attention network (DAN). We questioned whether neglect-related behavioral deficits may be determined by local dysfunction of a specific region within these brain networks. We investigated acute right-hemisphere stroke patients with left hemispatial neglect using resting-state functional MRI, neuropsychological tests of spatial attention and clinical assessment of neglect-related functional disability. In addition to conventional FC analyses between different cortical regions of interest (ROIs) in the DAN/VAN, we extracted the fractional amplitude of low frequency fluctuations (fALFF) from each ROI as a marker of regional spontaneous neuronal activity. Although DAN regions (as opposed to the VAN regions) were largely spared from structural brain damage, they exhibited a significant reduction of inter-hemispheric FC. However, significant fMRI-behavior correlations were revealed specifically for the fALFF of one DAN-ROI in the right superior parietal lobule (SPL): the smaller the fALFF in the right posterior intraparietal sulcus, the more severe the patient's pathological attention bias and neglect-related functional impairment. In line with 'diaschisis', our findings confirm a crucial role of the non-lesioned but dysfunctional right SPL for the emergence of spatial neglect and its behavioral consequences. They further support targeting the SPL dysfunction by non-invasive brain stimulation in neglect rehabilitation.


Assuntos
Viés de Atenção/fisiologia , Córtex Cerebral/fisiopatologia , Lateralidade Funcional/fisiologia , Neuroimagem Funcional , Rede Nervosa/fisiopatologia , Lobo Parietal/fisiopatologia , Transtornos da Percepção/fisiopatologia , Percepção Espacial/fisiologia , Idoso , Córtex Cerebral/diagnóstico por imagem , Conectoma , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Rede Nervosa/diagnóstico por imagem , Transtornos da Percepção/etiologia , Acidente Vascular Cerebral/complicações
16.
Neurology ; 94(6): e564-e574, 2020 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-31941797

RESUMO

OBJECTIVE: To validate the current criteria of visual snow and to describe its common phenotype using a substantial clinical database. METHODS: We performed a web-based survey of patients with self-assessed visual snow (n = 1,104), with either the complete visual snow syndrome (n = 1,061) or visual snow without the syndrome (n = 43). We also describe a population of patients (n = 70) with possible hallucinogen persisting perception disorder who presented clinically with visual snow syndrome. RESULTS: The visual snow population had an average age of 29 years and had no sex prevalence. The disorder usually started in early life, and ≈40% of patients had symptoms for as long as they could remember. The most commonly experienced static was black and white. Floaters, afterimages, and photophobia were the most reported additional visual symptoms. A latent class analysis showed that visual snow does not present with specific clinical endophenotypes. Severity can be classified by the amount of visual symptoms experienced. Migraine and tinnitus had a very high prevalence and were independently associated with a more severe presentation of the syndrome. CONCLUSIONS: Clinical characteristics of visual snow did not differ from the previous cohort in the literature, supporting validity of the current criteria. Visual snow likely represents a clinical continuum, with different degrees of severity. On the severe end of the spectrum, it is more likely to present with its common comorbid conditions, migraine and tinnitus. Visual snow does not depend on the effect of psychotropic substances on the brain.


Assuntos
Transtornos da Percepção/fisiopatologia , Transtornos da Visão/fisiopatologia , Adulto , Pós-Imagem , Comorbidade , Endofenótipos , Feminino , Alucinógenos/efeitos adversos , Humanos , Análise de Classes Latentes , Masculino , Transtornos de Enxaqueca/epidemiologia , Enxaqueca com Aura/epidemiologia , Cegueira Noturna/epidemiologia , Cegueira Noturna/fisiopatologia , Transtornos da Percepção/induzido quimicamente , Transtornos da Percepção/epidemiologia , Fotofobia/epidemiologia , Fotofobia/fisiopatologia , Prevalência , Índice de Gravidade de Doença , Síndrome , Zumbido/epidemiologia , Transtornos da Visão/induzido quimicamente , Transtornos da Visão/epidemiologia , Visão Intraocular , Adulto Jovem
17.
Neuropsychologia ; 138: 107337, 2020 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-31923525

RESUMO

The disownership of body parts, that most frequently occurs on the left side of the body, contralateral to right-hemispheric lesions, is an infrequent disorder, as usually assessed by interviews asking for dichotomic "yes/no" responses. This observational study in right-brain-damaged stroke patients investigated the efficacy of a continuous Visual Analog Scale (VAS) to detect body disownership after right brain damage, compared to dichotomic questions. Thirty-two right-handed right-brain-damaged stroke patients were given a Standardized Interview (SI), asking "Whose hand/arm/leg is this?", followed by a VAS (asking patients to mark on a vertical line their agreement with the statement that a body part belonged to them). The neural correlates of this disorder and measures of extra-personal and personal spatial neglect were also assessed. Control data were recorded from 18 neurologically unimpaired right-handed participants. During the interview, no patient showed disownership of body parts. Conversely, on the VAS eight out of 32 (25%) patients' scores, but none of the controls' scores, indicated a judgement of disownership for left body parts, with a left-right difference larger than that of control participants. VAS-detected disownership was not systematically associated with extra-personal and personal unilateral spatial neglect. Lesion sites associated with disownership of left body parts included the caudate nucleus and the anterior part of the internal capsule. To conclude, the VAS task, compared to the interview, is a novel tool to detect disownership of left body parts in right brain-damaged patients. A revised classification of body-ownership disorders is proposed. The present variant, assessed and detected by the VAS task, is termed Covert disownership and distinguished from the Overt disownership assessed by a SI.


Assuntos
Núcleo Caudado/patologia , Lateralidade Funcional/fisiologia , Cápsula Interna/patologia , Testes Neuropsicológicos , Transtornos da Percepção/fisiopatologia , Percepção Espacial/fisiologia , Acidente Vascular Cerebral/patologia , Acidente Vascular Cerebral/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Imagem Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Propriedade , Transtornos da Percepção/etiologia , Psicometria , Acidente Vascular Cerebral/complicações
18.
Psicológica (Valencia. Internet) ; 41(1): 66-83, ene. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-193630

RESUMO

The right parietal cortex has been widely associated with a spatial orienting network. Its damage frequently produces the Neglect syndrome consisting in deficits in spatial attention to the left hemifield. Neglect has also been related to temporal deficits (such as the estimation of the duration of a stimulus or the discrimination of two stimuli that occur at the same spatial location but at different time intervals). Such attentional deficits have been much less studied in the temporal as compared to the spatial domain. The current research focused on the study of temporal attention processes in patients with Neglect syndrome, specifically, on temporal preparation. We recruited 10 patients with Neglect syndrome, 10 patients without Neglect syndrome, as well as 11 healthy individuals. Each participant completed an experimental task which measures three main temporal preparation effects described in the literature: Temporal orienting and Foreperiod effects (both related to control mechanisms and prefrontal areas) and Sequential effects (automatic in nature and related to parietal and subcortical structures). The results showed a deficit in the sequential effects only in those patients who suffered from Neglect syndrome. The results suggest a causal relation between Neglect syndrome and the automatic mechanisms of temporal preparation. Since our sample of Neglect patients had suffered lesions mainly in the parietal cortex, the results are discussed taking into account the role of the parietal lobe in the processing of time and the models explaining sequential effects


La corteza parietal derecha ha sido asociada con una red de orientación espacial. Su daño produce frecuentemente el síndrome de Heminegligencia que consiste en déficits en la atención espacial al hemicampo izquierdo. Dicho síndrome también se ha relacionado con déficits temporales (como la estimación de la duración de un estímulo o la discriminación de dos estímulos que ocurren en la misma ubicación espacial pero en diferentes intervalos de tiempo). Sin embargo, tales déficits atencionales han sido menos estudiados en el ámbito temporal que en el espacial. La presente investigación pretende el estudio de los procesos de atención temporal en pacientes con síndrome de Heminegligencia. Se reclutaron 10 pacientes con síndrome de Heminegligencia, 10 pacientes sin Heminegligencia y 11 individuos sanos. Cada participante realizó una tarea experimental que estudia tres efectos principales de preparación temporal descritos en la literatura: Orientación temporal y Foreperiod (ambos relacionados con mecanismos de control y áreas prefrontales) y Efectos secuenciales (de naturaleza más automática y relacionados con estructuras parietales y subcorticales). Los resultados mostraron un déficit en los efectos secuenciales únicamente en los pacientes con Heminegligencia. Esto sugiere una relación causal entre el síndrome de Heminegligencia y los mecanismos automáticos de preparación temporal. Dado que nuestra muestra de pacientes heminegligentes había sufrido lesiones principalmente en la corteza parietal, los resultados se discuten teniendo en cuenta el papel del lóbulo parietal en el procesamiento del tiempo, y en el marco de los modelos que explican los efectos secuenciales


Assuntos
Humanos , Lobo Temporal/lesões , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Lateralidade Funcional/fisiologia , Transtornos da Percepção/fisiopatologia , Transtornos da Percepção/psicologia , Análise de Variância , Transtornos da Percepção/diagnóstico
19.
J Neurol ; 267(1): 95-99, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31562560

RESUMO

Alien limb syndrome following stroke within the territory of the posterior cerebral artery is exceedingly rare. A right-handed female experienced left homonymous hemianopia, visuospatial neglect, and proprioceptive loss of her left hemi-body. She experienced unintended, involuntary movements of her left arm and hand, which interfered with and disturbed motor actions of daily life performed with her right upper limb. There was no denial of ownership, but she interpreted movements of her left upper limb to be annoying, out of her will and unwanted. The alien limb phenomenon improved in parallel with improvement of proprioceptive loss over a 12-week of in-patient rehabilitation. A recently proposed theoretical concept of the alien limb phenomenon after posterior artery stroke is discussed.


Assuntos
Infarto da Artéria Cerebral Posterior/complicações , Transtornos da Percepção/etiologia , Transtornos da Percepção/fisiopatologia , Propriocepção/fisiologia , Extremidade Superior/fisiopatologia , Idoso , Feminino , Hemianopsia/etiologia , Hemianopsia/fisiopatologia , Humanos
20.
Clin Neurophysiol ; 131(1): 330-342, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31506235

RESUMO

OBJECTIVE: Altered brain functional connectivity has been shown in youth with attention-deficit/hyperactivity disorder (ADHD). However, relatively little is known about functional connectivity in adult ADHD, and how it is linked with the heritability of ADHD. METHODS: We measured eyes-open and eyes-closed resting electroencephalography (EEG) from 38 adults with ADHD, 45 1st degree relatives of people with ADHD and 51 healthy controls. Functional connectivity among all scalp channels was calculated using a weighted phase lag index for delta, theta, alpha, beta and gamma frequency bands. A machine learning analysis using penalized linear regression was used to identify if connectivity features (10,080 connectivity pairs) could predict ADHD symptoms. Furthermore, we examined if EEG connectivity could accurately classify participants into ADHD, 1st degree relatives and/or control groups. RESULTS: Hyperactive symptoms were best predicted by eyes-open EEG connectivity in delta, beta and gamma bands. Inattentive symptoms were predicted by eyes-open EEG connectivity in delta, alpha and gamma bands, and eyes-closed EEG connectivity in delta and gamma bands. EEG connectivity features did not reliably classify participants into groups. CONCLUSIONS: EEG connectivity may represent a neuromarker for ADHD symptoms. SIGNIFICANCE: EEG connectivity may help elucidate the neural basis of adult ADHD symptoms.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Conectoma , Eletroencefalografia/métodos , Adulto , Ritmo alfa/fisiologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Ritmo beta/fisiologia , Estudos de Casos e Controles , Ritmo Delta/fisiologia , Feminino , Ritmo Gama/fisiologia , Humanos , Modelos Lineares , Aprendizado de Máquina , Masculino , Pais , Transtornos da Percepção/fisiopatologia , Agitação Psicomotora/fisiopatologia , Irmãos , Avaliação de Sintomas , Ritmo Teta/fisiologia
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