Development of the Halifax Visual Scanning Test: A New Measure of Visual-Spatial Neglect for Personal, Peripersonal, and Extrapersonal Space

Objectives: Visual-spatial neglect is a common attentional disorder after right-hemisphere stroke and is associated with poor rehabilitation outcomes. The presence of neglect symptoms has been reported to vary across personal, peripersonal, and extrapersonal space. Currently, no measure is available to assess neglect severity equally across these spatial regions and may be missing subsets of symptoms or patients with neglect entirely. We sought to provide initial construct validity for a novel assessment tool that measures neglect symptoms equally for these spatial regions: the Halifax Visual Scanning Test (HVST). Methods: In Study I, the HVST was compared to conventional measures of neglect and functional outcome scores (wheelchair navigation) in 15 stroke inpatients and 14 healthy controls. In Study II, 19 additional controls were combined with the control data from Study I to establish cutoffs for impairment. Patterns of neglect in the stroke group were examined. Results: In Study I, performance on all HVST subtests were correlated with the majority of conventional subtests and wheelchair navigation outcomes. In Study II, neglect-related deficits in visual scanning showed dissociations across spatial regions. Four inpatients exhibited symptoms of neglect on the HVST that were not detected on conventional measures, one of which showed symptoms in personal and extrapersonal space exclusively. Conclusions: The HVST appears a useful measure of neglect symptoms in different spatial regions that may not be detected with conventional measures and that correlates with functional wheelchair performance. Preliminary control data are presented and further research to add to this normative database appears warranted. (JINS, 2019, 25, 490–500)

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Disconnections in Personal Neglect

10.21203/rs.3.rs-1126909/v1 ◽

2021 ◽

Author(s):

Sara Bertagnoli ◽

Valentina Pacella ◽

Elena Rossato ◽

Paul M Jenkinson ◽

Akaterini Fotopoulou ◽

...

Keyword(s):

White Matter ◽

Right Hemisphere ◽

Temporal Cortex ◽

Lesion Size ◽

The Body ◽

Spatial Neglect ◽

Small Samples ◽

Motor Deficits ◽

The Novel ◽

Extrapersonal Space

Abstract Personal neglect is a disorder in the perception and representation of the body that causes the patients to behave as if the contralesional side of their body does not exist. This clinical condition has not been adequately investigated in the past as it has been considered a symptom of unilateral spatial neglect, which has mainly been studied with reference to extrapersonal space. Only a few studies with small samples have investigated the neuroanatomical correlates of personal neglect, and these have mainly focused on discrete cortical lesions and modular accounts, as well as being based on the hypothesis that this disorder is associated with somatosensory and spatial deficits. In the present study, we tested the novel hypothesis that personal neglect may be associated not only with discrete cortical and subcortical lesions, but also with disconnections of white matter tracts. We performed an advanced lesion analyses in a large sample of 104 right hemisphere damaged patients, 68 of whom were suffering from personal neglect. Results from the analyses of the grey and white matter were controlled for co-occurrent clinical variables such as extrapersonal neglect, anosognosia for hemiplegia and motor deficits, along with other lesion-related variables such as lesion size, the interval from the lesion onset to neuroimaging recordings. Our results reveal that personal neglect is associated with lesions in a medial network which involves the temporal cortex (Heschl’s gyrus), the ventro-lateral nuclei of the thalamus, and the fornix. This suggests that personal neglect involves a convergence between sensorimotor processes, spatial representation and the processing of self-referred information (episodic memory).

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Visual-spatial neglect after right-hemisphere stroke

Chinese Medical Journal ◽

10.1097/cm9.0000000000000218 ◽

2019 ◽

Vol 132 (9) ◽

pp. 1063-1070 ◽

Cited By ~ 1

Author(s):

Lin-Lin Ye ◽

Lei Cao ◽

Huan-Xin Xie ◽

Gui-Xiang Shan ◽

Yan-Ming Zhang ◽

...

Keyword(s):

Right Hemisphere ◽

Spatial Neglect ◽

Visual Spatial ◽

Right Hemisphere Stroke

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Unilateral spatial neglect: Relation to rehabilitation outcomes in patients with right hemisphere stroke

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2004.10.029 ◽

2005 ◽

Vol 86 (4) ◽

pp. 763-767 ◽

Cited By ~ 102

Author(s):

Robert Gillen ◽

Howard Tennen ◽

Tara McKee

Keyword(s):

Right Hemisphere ◽

Spatial Neglect ◽

Unilateral Spatial Neglect ◽

Rehabilitation Outcomes ◽

Right Hemisphere Stroke

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Interaction between spatial neglect and attention deficit in patients with right hemisphere damage

Cortex ◽

10.1016/j.cortex.2021.03.036 ◽

2021 ◽

Author(s):

Yusaku Takamura ◽

Shintaro Fujii ◽

Satoko Ohmatsu ◽

Koki Ikuno ◽

Kohei Tanaka ◽

...

Keyword(s):

Attention Deficit ◽

Right Hemisphere ◽

Spatial Neglect ◽

Right Hemisphere Damage

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Brain Network Dysfunction in Poststroke Delirium and Spatial Neglect: An fMRI Study

Stroke ◽

10.1161/strokeaha.121.035733 ◽

2021 ◽

Author(s):

Olga Boukrina ◽

Mateusz Kowalczyk ◽

Yury Koush ◽

Yekyung Kong ◽

A.M. Barrett

Keyword(s):

Right Hemisphere ◽

Functional Neuroimaging ◽

Brain Network ◽

Spatial Neglect ◽

Stroke Recovery ◽

Network Activity ◽

Brain Disorder ◽

Fmri Study ◽

The Right ◽

Right Hemisphere Stroke

Background and Purpose: Delirium, an acute reduction in cognitive functioning, hinders stroke recovery and contributes to cognitive decline. Right-hemisphere stroke is linked with higher delirium incidence, likely, due to the prevalence of spatial neglect (SN), a right-brain disorder of spatial processing. This study tested if symptoms of delirium and SN after right-hemisphere stroke are associated with abnormal function of the right-dominant neural networks specialized for maintaining attention, orientation, and arousal. Methods: Twenty-nine participants with right-hemisphere ischemic stroke undergoing acute rehabilitation completed delirium and SN assessments and functional neuroimaging scans. Whole-brain functional connectivity of 4 right-hemisphere seed regions in the cortical-subcortical arousal and attention networks was assessed for its relationship to validated SN and delirium severity measures. Results: Of 29 patients, 6 (21%) met the diagnostic criteria for delirium and 16 (55%) for SN. Decreased connectivity of the right basal forebrain to brain stem and basal ganglia predicted more severe SN. Increased connectivity of the arousal and attention network regions with the parietal, frontal, and temporal structures in the unaffected hemisphere was also found in more severe delirium and SN. Conclusions: Delirium and SN are associated with decreased arousal network activity and an imbalance of cortico-subcortical hemispheric connectivity. Better understanding of neural correlates of poststroke delirium and SN will lead to improved neuroscience-based treatment development for these disorders.

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Stroke

Psychiatric Aspects of Neurologic Diseases ◽

10.1093/oso/9780195309430.003.0010 ◽

2008 ◽

Author(s):

Hochang Ben Lee ◽

John R. Lipsey

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Vascular Dementia ◽

Cognitive Deficits ◽

Cognitive Rehabilitation ◽

Right Hemisphere ◽

Stroke Survivors ◽

Language Therapy ◽

Rehabilitation Outcomes ◽

Psychiatric Complication

With an annual incidence of more than 600,000 cases, thromboembolic stroke is the third leading cause of death in the United States after heart disease and cancer (Kochanek et al., 2004). The number of stroke survivors has increased to 4.5 million adults nationally as the management of acute stroke continues to improve (AHA, 2002). Psychiatric syndromes are common complications of stroke and are associated with psychologic distress, increased impairment, poor rehabilitation outcomes, and excess morbidity. The purpose of this chapter is to describe clinically important poststroke psychiatric disorders and suggest appropriate treatment. Cognitive deficits are the most common psychiatric complication of stroke and affect nearly all stroke survivors. The type of cognitive disturbance depends on the location of the brain injury. Left hemisphere strokes frequently cause aphasia. Right hemisphere strokes cause substantial (but often underrecognized) cognitive impairments such as diminished insight, decreased attention, impaired spatial reasoning, and neglect syndromes. Furthermore, depending on the location of a stroke, other functions such as motivation, memory, judgment, and impulse control may also be affected. A large stroke or a series of small strokes affecting both hemispheres may lead to the global cognitive impairment of dementia. When a series of strokes is involved, the cognitive decline develops in a stepwise manner. This vascular dementia or multi-infarct dementia may be difficult to distinguish from Alzheimer’s disease. Autopsy studies of patients diagnosed with vascular dementia have often demonstrated the presence of Alzheimer’s disease pathology. As many as 25% of all dementia cases are attributable to a combined neuropathology of Alzheimer’s disease and multiple infarcts (Massoud et al., 1999). In addition to strategies such as speech and language therapy, physical and occupational therapy, and cognitive rehabilitation, pharmacologic treatment may improve cognitive deficits in some stroke patients. The parallels between vascular dementia and Alzheimer’s disease, as well as the evidence that reduced cholinergic function may play a role in both (Gottfries et al., 1994) have encouraged the use of acetylcholinesterase inhibitors (eg, donepezil) in vascular dementia. These drugs have shown modest benefits in such patients (Roman et al., 2005), and their use is described in Chapter 20.

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Functional MRI neuroanatomic correlates of the Hooper Visual Organization Test

Journal of the International Neuropsychological Society ◽

10.1017/s1355617704107042 ◽

2004 ◽

Vol 10 (7) ◽

pp. 939-947 ◽

Cited By ~ 16

Author(s):

CHAD H. MORITZ ◽

STERLING C. JOHNSON ◽

KATHRYN M. MCMILLAN ◽

VICTOR M. HAUGHTON ◽

M. ELIZABETH MEYERAND

Keyword(s):

Right Hemisphere ◽

Parietal Lobe ◽

Neuropsychological Test ◽

Occipital Cortex ◽

Normal Subjects ◽

Object Identification ◽

Visual Spatial ◽

Dorsolateral Prefrontal ◽

Fmri Analysis ◽

Visual Organization

The Hooper Visual Organization Test (VOT), a commonly applied neuropsychological test of visual spatial ability, is used for assessing patients with suspected right hemisphere, or parietal lobe involvement. A controversy has developed over whether the inferences of this test metric can be assumed to involve global, lateralized, or regional functionality. In this study, the characteristic visual organization and object naming aspects of the VOT task presentation were adapted to a functional MR imaging (fMRI) paradigm to probe the neuroanatomic correlates of this neuropsychological test. Whole brain fMRI mapping results are reported on a cohort of normal subjects. Bilateral fMRI responses were found predominantly in the posterior brain, in regions of superior parietal lobules, ventral temporal-occipital cortex, and posterior visual association areas, and to a lesser extent, the frontal eye fields bilaterally, and left dorsolateral prefrontal cortex. The results indicate a general brain region or network in which VOT impairment, due to its visuospatial and object identification demands, is possible to be detected. Discussion is made of interpretive limitations when adapting neuropsychological tests to fMRI analysis. (JINS, 2004, 10, 939–947.)

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Regional Shape Abnormalities in Thalamus and Verbal Memory Impairment After Subcortical Infarction

Neurorehabilitation and Neural Repair ◽

10.1177/1545968319846121 ◽

2019 ◽

Vol 33 (6) ◽

pp. 476-485 ◽

Cited By ~ 2

Author(s):

Gang Liu ◽

Xiaoqing Tan ◽

Chao Dang ◽

Shuangquan Tan ◽

Shihui Xing ◽

...

Keyword(s):

Left Hemisphere ◽

Verbal Memory ◽

Memory Impairment ◽

Right Hemisphere ◽

Brain Structures ◽

Change Rate ◽

Immediate Recall ◽

Stroke Group ◽

Left Hemisphere Stroke ◽

Subcortical Infarction

Background. Subcortical infarcts can result in verbal memory impairment, but the potential underlying mechanisms remain unknown. Objective. We investigated the spatiotemporal deterioration patterns of brain structures in patients with subcortical infarction and identified the regions that contributed to verbal memory impairment. Methods. Cognitive assessment and structural magnetic resonance imaging were performed 1, 4, and 12 weeks after stroke onset in 28 left-hemisphere and 22 right-hemisphere stroke patients with subcortical infarction. Whole-brain volumetric analysis combined with a further-refined shape analysis was conducted to analyze longitudinal morphometric changes in brain structures and their relationship to verbal memory performance. Results. Between weeks 1 and 12, significant volume decreases in the ipsilesional basal ganglia, inferior white matter, and thalamus were found in the left-hemisphere stroke group. Among those 3 structures, only the change rate of the thalamus volume was significantly correlated with that in immediate recall. For the right-hemisphere stroke group, only the ipsilesional basal ganglia survived the week 1 to week 12 group comparison, but its change rate was not significantly correlated with the verbal memory change rate. Shape analysis of the thalamus revealed atrophies of the ipsilesional thalamic subregions connected to the prefrontal, temporal, and premotor cortices in the left-hemisphere stroke group and positive correlations between the rates of those atrophies and the change rate in immediate recall. Conclusions. Secondary damage to the thalamus, especially to the left subregions connected to specific cortices, may be associated with early verbal memory impairment following an acute subcortical infarct.

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Prism adaptation treatment for spatial neglect post brain tumour removal: A case report

Hong Kong Journal of Occupational Therapy ◽

10.1177/1569186120921472 ◽

2020 ◽

pp. 156918612092147

Author(s):

Peii Chen ◽

Viktoriya Lander ◽

Natalia Noce ◽

Kimberly Hreha

Keyword(s):

Neural Networks ◽

Case Report ◽

Brain Tumour ◽

Prism Adaptation ◽

Spatial Neglect ◽

Assessment Process ◽

Proper Treatment ◽

Rehabilitation Outcomes ◽

Tumour Removal ◽

Patient Reported

Purpose/aim: Spatial neglect is caused by damage to neural networks critical for spatial attention. Spatial neglect without proper treatment impedes rehabilitation outcomes. Prism adaptation treatment, a visuomotor protocol, has been used with stroke survivors with spatial neglect to improve function. This case report explored the feasibility and potential effects of prism adaptation treatment in an individual with spatial neglect after glioblastoma removal. Methods Feasibility was designed and tested to include acceptability and implementation. Exploratory aim on the effectiveness of the intervention was determined using the Catherine Bergego Scale via the Kessler Foundation Neglect Assessment Process, star cancellation, line bisection and scene copying. Results The patient reported favouring the treatment. Eight sessions, one session a day, were completed over two weeks. The patient’s spatial neglect symptoms reduced on all assessments. Conclusion Prism adaptation treatment was feasible and effective; however, further research is needed to understand the complete benefits of prism adaptation treatment in this population.

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