scholarly journals Brain Activations During Optokinetic Stimulation in Acute Right-Hemisphere Stroke Patients and Hemispatial Neglect: An fMRI Study

2019 ◽  
Vol 33 (7) ◽  
pp. 581-592
Author(s):  
Janina von der Gablentz ◽  
Inga Könemund ◽  
Andreas Sprenger ◽  
Wolfgang Heide ◽  
Marcus Heldmann ◽  
...  
Keyword(s):  
Visual Cortex ◽  
Spatial Attention ◽  
Right Hemisphere ◽  
Attention Bias ◽  
Oculomotor Control ◽  
Optokinetic Stimulation ◽  
Hemispatial Neglect ◽  
Neural Basis ◽  
Stroke Patients ◽  
Right Hemisphere Stroke

Objective. Leftward optokinetic stimulation (OKS) is a promising therapeutic approach for right-hemisphere stroke patients with left hemispatial neglect. We questioned whether the putative neural basis is an activation of frontoparietal brain regions involved in the control of eye movements and spatial attention. Methods. We used functional magnetic resonance imaging to investigate brain activations during OKS in acute right-hemisphere stroke patients (RHS, n = 19) compared with healthy control subjects (HC, n = 9). Based on neuropsychological testing we determined the ipsilesional attention bias in all RHS patients, 11 showed manifest hemispatial neglect. Results. In HC subjects, OKS in either direction led to bilateral activation of the visual cortex (V1-V4), frontal (FEF) and supplementary (SEF) eye fields, intraparietal sulcus (IPS), basal ganglia, and thalamus. RHS patients’ activations were generally reduced compared with HC. Nevertheless, leftward OKS bilaterally activated the visual cortex (V1-V4), FEF, SEF, IPS, and thalamus. The neural response to OKS was negatively correlated with patients’ behavioral impairment: The greater the individual attention bias/neglect the weaker the brain activations. Conclusion. In RHS patients, leftward OKS activates frontoparietal regions (FEF, IPS) that are spared from structural brain damage and functionally involved in both oculomotor control and spatial attention. This may provide a neural basis for the known therapeutic effects of OKS on hemispatial neglect. In acute stroke stages, reduced activation levels correlating with neglect severity indicate functional downregulation of the underlying dorsal attention network. Therefore, chronic RHS patients with less severe neglect after recovery of network disturbances may be more suitable candidates for OKS rehabilitation.

scholarly journals Inconsistency of performance on neglect subtype tests following acute right hemisphere stroke

2007 ◽  
Vol 14 (1) ◽  
pp. 23-32 ◽  
Author(s):  
R.H. HAMILTON ◽  
H.B. COSLETT ◽  
L.J. BUXBAUM ◽  
J. WHYTE ◽  
M.K. FERRARO
Keyword(s):  
Prognostic Value ◽  
Right Hemisphere ◽  
Hemispatial Neglect ◽  
Stroke Patients ◽  
The Third ◽  
Performance Patterns ◽  
Multiple Symptoms ◽  
Patient Performance ◽  
Over Time ◽  
Right Hemisphere Stroke

Hemispatial neglect has been conceptualized as having dissociable and potentially clinically relevant subtypes. However, the question of whether patient performance on neglect subtype measures is consistent over time remains largely unanswered. We examined changes in performance over time on measures of motor, perceptual, and personal neglect in 21 patients with neglect from acute right hemisphere stroke. Patients were assessed on three occasions, separated by at least one week, using a lateralized target test, lateralized response test, and modified fluff test. Across three testing timepoints, 18 (85.7%) patients changed subtype performance patterns at least once. In 13 (61.9%) of these patients, inconsistency between timepoints was not adequately accounted for by recovery. On initial testing, seven, patients (33.3%) demonstrated more than one neglect subtype symptom; by the third testing timepoint none of the patients demonstrated multiple symptoms. In the setting of acute stroke, performance on three measures of neglect symptoms is inconsistent across time. However, the distribution of neglect subtype symptoms appears to become more discrete over time. These findings complicate our understanding of the pathophysiology and potential prognostic value of neglect subtypes, and suggest that treatment decisions based on subtype performance assessed at a single timepoint, may be of limited utility. (JINS, 2008,14, 23–32.)

scholarly journals Is Lateropulsion Really Related with a Specific Lesion of the Brain?

2021 ◽  
Vol 11 (3) ◽  
pp. 354
Author(s):  
Kyoung Lee ◽  
Sang Yoo ◽  
Eun Ji ◽  
Woo Hwang ◽  
Yeun Yoo ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Parietal Lobe ◽  
Inferior Frontal Gyrus ◽  
Brain Lesions ◽  
Vertical Posture ◽  
Lesion Volume ◽  
Precentral Gyrus ◽  
Stroke Patients ◽  
The Right ◽  
Right Hemisphere Stroke

Lateropulsion (pusher syndrome) is an important barrier to standing and gait after stroke. Although several studies have attempted to elucidate the relationship between brain lesions and lateropulsion, the effects of specific brain lesions on the development of lateropulsion remain unclear. Thus, the present study investigated the effects of stroke lesion location and size on lateropulsion in right hemisphere stroke patients. The present retrospective cross-sectional observational study assessed 50 right hemisphere stroke patients. Lateropulsion was diagnosed and evaluated using the Scale for Contraversive Pushing (SCP). Voxel-based lesion symptom mapping (VLSM) analysis with 3T-MRI was used to identify the culprit lesion for SCP. We also performed VLSM controlling for lesion volume as a nuisance covariate, in a multivariate model that also controlled for other factors contributing to pusher behavior. VLSM, combined with statistical non-parametric mapping (SnPM), identified the specific region with SCP. Lesion size was associated with lateropulsion. The precentral gyrus, postcentral gyrus, inferior frontal gyrus, insula and subgyral parietal lobe of the right hemisphere seemed to be associated with the lateropulsion; however, after adjusting for lesion volume as a nuisance covariate, no lesion areas were associated with the SCP scores. The size of the right hemisphere lesion was the only factor most strongly associated with lateropulsion in patients with stroke. These results may be useful for planning rehabilitation strategies of restoring vertical posture and understanding the pathophysiology of lateropulsion in stroke patients.

scholarly journals The Presence of Visual Neglect after Thrombolytic Treatment in Patients with Right Hemisphere Stroke

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
J. E. Kettunen ◽  
M. Nurmi ◽  
A.-M. Koivisto ◽  
P. Dastidar ◽  
M. Jehkonen
Keyword(s):  
Right Hemisphere ◽  
Stroke Severity ◽  
Study Group ◽  
Thrombolytic Treatment ◽  
Visual Neglect ◽  
Stroke Patients ◽  
Neuropsychological Examination ◽  
The Difference ◽  
Right Hemisphere Stroke

Visual neglect (VN) is a common consequence of right hemisphere (RH) stroke. The aims of this study were to explore the presence of VN after RH stroke in the patients with (T+) or without (T−) thrombolytic treatment, and to determine whether thrombolysis is a predictor of VN. The study group consisted of 77 RH infarct patients. VN was evaluated with six conventional subtests of the Behavioural Inattention Test (BIT). Stroke severity was assessed using the National Institute of Health Stroke Scale (NIHSS). In the neuropsychological examination, 22% of all RH stroke patients had VN. VN was present in 15% of the patients in the T+ group and in 28% of the patients in the T− group, but the difference was not statistically significant. Despite that, patients in the T− group had a higher risk of VN than patients in the T+ group. Our results suggest that thrombolysis independently predicted absence of VN.

The Company Prosodic Deficits Keep Following Right Hemisphere Stroke: A Systematic Review

2022 ◽  
pp. 1-16
Author(s):  
Shannon M. Sheppard ◽  
Melissa D. Stockbridge ◽  
Lynsey M. Keator ◽  
Laura L. Murray ◽  
Margaret Lehman Blake ◽  
...  
Keyword(s):  
Systematic Review ◽  
Right Hemisphere ◽  
Research Literature ◽  
Future Research ◽  
Sufficient Information ◽  
Hemispatial Neglect ◽  
Specific Patient ◽  
Empirical Inquiry ◽  
Communication Deficits ◽  
Right Hemisphere Stroke

Abstract Objectives: The aim of this systematic review was to identify the presence and nature of relationships between specific forms of aprosodia (i.e., expressive and receptive emotional and linguistic prosodic deficits) and other cognitive-communication deficits and disorders in individuals with right hemisphere damage (RHD) due to stroke. Methods: One hundred and ninety articles from 1970 to February 2020 investigating receptive and expressive prosody in patients with relatively focal right hemisphere brain damage were identified via database searches. Results: Fourteen articles were identified that met inclusion criteria, passed quality reviews, and included sufficient information about prosody and potential co-occurring deficits. Twelve articles investigated receptive emotional aprosodia, and two articles investigated receptive linguistic aprosodia. Across the included studies, receptive emotional prosody was not systematically associated with hemispatial neglect, but did co-occur with deficits in emotional facial recognition, interpersonal interactions, or emotional semantics. Receptive linguistic processing was reported to co-occur with amusia and hemispatial neglect. No studies were found that investigated the co-occurrence of expressive emotional or linguistic prosodic deficits with other cognitive-communication impairments. Conclusions: This systematic review revealed significant gaps in the research literature regarding the co-occurrence of common right hemisphere disorders with prosodic deficits. More rigorous empirical inquiry is required to identify specific patient profiles based on clusters of deficits associated with right hemisphere stroke. Future research may determine whether the co-occurrences identified are due to shared cognitive-linguistic processes, and may inform the development of evidence-based assessment and treatment recommendations for individuals with cognitive-communication deficits subsequent to RHD.

scholarly journals Influence of age, lesion volume, and damage to dorsal versus ventral streams to viewer- and stimulus-centered hemispatial neglect in acute right hemisphere stroke

Cortex ◽  
2020 ◽  
Vol 126 ◽  
pp. 73-82
Author(s):  
Adrian Suarez ◽  
Sadhvi Saxena ◽  
Kenichi Oishi ◽  
Kumiko Oishi ◽  
Alexandra Walker ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Lesion Volume ◽  
Hemispatial Neglect ◽  
Right Hemisphere Stroke

Predictors of falls among right-hemisphere stroke patients in the rehabilitation setting

1993 ◽  
Vol 74 (6) ◽  
pp. 621-626 ◽  
Author(s):  
Lisa J. Rapport ◽  
Jeffrey S. Webster ◽  
Kirstin L. Flemming ◽  
John W. Lindberg ◽  
M. Catherine Godlewski ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Stroke Patients ◽  
Right Hemisphere Stroke
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