scholarly journals THE ASSOCIATION BETWEEN LOCATION OF BRAIN LESION AND FINDINGS OF FLEXIBLE ENDOSCOPIC EVALUATION OF SWALLOWING (FEES) IN STROKE PATIENTS: WHICH EXERCISE IS BENEFICIAL?

2019 ◽  
Author(s):  
Widjajalaksmi Kusumaningsih ◽  
Nur Indah Lestari ◽  
Herdiman Purba
Keyword(s):  
Brain Stem ◽  
Right Hemisphere ◽  
Brain Lesion ◽  
Retrospective Chart Review ◽  
Brain Regions ◽  
Cortical Lesion ◽  
Neurogenic Dysphagia ◽  
Stroke Patients ◽  
Subcortical Lesion ◽  
Strengthening Exercise

Abstract Background: Dysphagia is a frequent occurrence following stroke. Various brain regions have been shown to control deglutition. However, it is still controversial as to which of the two hemispheres plays more important role in deglutition, and which injured hemisphere is more likely to cause the specific patterns of dysphagia seen in stroke patients. An accurate estimate of the incidence of dysphagia will be critical to assess benefits of dysphagia interventions. Objective: To investigate whether patterns of dysphagia are associated with the location of brain lesion in stroke patients and to examine whether pharyngeal strengthening exercise and hyolaryngeal exercise are proper for patients, based on the findings of FEES and location of brain lesion. Methods: The subjects were stroke outpatients who visited our clinic from January 2016 to April 2018. To localize brain lesion, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) have been employed. The locations of brain lesions were classified into cortical, subcortical, and brain stem. FEES was conducted to assess the patterns of deglutition disorders. These data were collected via retrospective chart review. Results: Of the 11 subjects, mean age (SD) was 62.73 (8.67) years and seven (63.64%) subjects were male. All subjects got ischemic stroke, eight (72.73%) had right hemispheric lesion and three (27.27%) had left hemispheric lesion. By brain lesion, there were nine subcortical, five cortical, and four brain stem lesions. All FEES findings, especially standing secretion, penetration, residue, and reduced hypopharynx sensitivity were higher in subcortical lesion, followed by brain stem and cortical lesion successively. Conclusion: Right hemisphere was involved more than left hemisphere in dysphagia patients. Standing secretion, penetration, residue, and reduced hypopharynx sensitivity occurs more often in subcortical lesion. Further studies on big samples in a perspective structure are needed. Based on this result, there is a place for pharyngeal strengthening exercise and hyolaryngeal complex range of motion and strengthening exercise to be implemented to the patients with neurogenic dysphagia after stroke.

scholarly journals Attention Deficits in Stroke Patients: The Role of Lesion Characteristics, Time from Stroke, and Concomitant Neuropsychological Deficits

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Simona Spaccavento ◽  
Chiara Valeria Marinelli ◽  
Roberto Nardulli ◽  
Luigi Macchitella ◽  
Umberto Bivona ◽  
...  
Keyword(s):  
Selective Attention ◽  
Right Hemisphere ◽  
Large Population ◽  
Brain Lesion ◽  
Chronic Phase ◽  
Hierarchical Organization ◽  
Attention Deficits ◽  
Stroke Patients ◽  
Rehabilitation Outcomes

Attention impairments are frequent in stroke patients with important consequences on the rehabilitation outcomes and quality of life. The aim of the study was to perform a comprehensive assessment of selective and intensive attention processes in a large population of brain-damaged patients, evaluating the influence of the side and site of the brain lesion, the time from stroke, and the concomitant presence of aphasia or neglect. We assessed 204 patients with a first unilateral brain lesion and 42 healthy individuals with three subtests of the Test of Attentional Performance (TAP): Alertness, Go-No Go, and Divided Attention. 44.4% of patients had an impairment in both intensive and selective aspects of attention, 5.6% had deficits only in the intensive component, and 31.8% had deficits only in selective tasks. More than 80% of the patients fell below the cut-off point on at least one task. Patients with a right hemispheric lesion (RHL) were more impaired than patients with a left hemispheric lesion (LHL) especially in tonic and phasic alertness. Patients with total anterior infarcts (TACI) presented the worst profile compared to other stroke subtypes, with a difference between total and lacunar subtypes in the Alertness test, independent of the presence of warning. Patients in the chronic phase had shorter RTs than acute patients only in the Alertness test. In patients with LHL, the presence of aphasia was associated with a greater deficit in selective attention. In patients with RHL, the presence of unilateral neglect was associated with impaired alertness and selective attention. Attention deficits are common after a unilateral first stroke. In keeping with the hierarchical organization of attention functions, results confirm the important role of the right hemisphere for the intensive components of attention, also highlighting the involvement of left hemisphere functioning for the selective aspects, possibly indicating a role of its linguistic functions.

scholarly journals Right-sided brain lesions predominate among patients with lesional mania: evidence from a systematic review and pooled lesion analysis

2018 ◽  
Author(s):  
J. Bernardo Barahona-Corrêa ◽  
Gonçalo Cotovio ◽  
Rui M. Costa ◽  
Ricardo Ribeiro ◽  
Ana Velosa ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Brain Lesion ◽  
Brain Regions ◽  
Brain Lesions ◽  
Supporting Evidence ◽  
Mood Regulation ◽  
Focal Lesions ◽  
Brain Areas ◽  
Lesion Topography ◽  
The Right

ABSTRACTBackgroundDespite claims that lesional mania is associated with right-hemisphere lesions, supporting evidence is scarce, and association with specific brain areas has not been demonstrated.AimsTo test whether focal brain lesions in lesional mania are more often right-than left-sided, and if lesions converge on areas relevant to mood regulation.MethodsWe performed a systematic literature search (PROSPERO registration CRD42016053675) on PubMed and Web-Of-Science, using terms that reflected diagnoses and structures of interest, and lesional mechanisms. Two researchers reviewed the articles separately according to PRISMA Guidelines, to select reports of adult-onset hypomania, mania or mixed state following a focal brain lesion. When available, eligible lesion images were manually traced onto the corresponding slices of MNI space, and lesion topography analyzed using standard brain atlases. Pooled-analyses of individual patient data were performed.ResultsData from 207 lesional mania patients was extracted from 110 reports. Among patients with focal lesions (N=197) more patients had lesions involving the right (84.3%) than the left (34.5%) hemisphere. Among 54 lesion images that were available, right-sided predominance of lesions was confirmed, and found to be was conserved across multiple brain regions, including the temporal lobe, fusiform gyrus and thalamus. These, in addition to several frontal lobe areas, were also identified as preferential lesion sites in comparisons with control lesions.ConclusionsPooled-analyses, based on the most comprehensive dataset of lesional mania available to date, confirm a preferential association with right-hemisphere lesions, while suggesting that several brain areas/circuits, relevant to mood regulation, are most frequently affected.

scholarly journals Auditory extinction and dichotic listening cv task in cerebral infarction preliminary report

1990 ◽  
Vol 48 (2) ◽  
pp. 201-203
Author(s):  
Mauro Muszkat ◽  
J. Osmar Cardeal ◽  
Clemente I. Ribeiro de Almeida ◽  
Maria Inez Campos ◽  
Carlos J. Reis de Campos
Keyword(s):  
Cerebral Infarction ◽  
Left Hemisphere ◽  
Dichotic Listening ◽  
Preliminary Report ◽  
Right Hemisphere ◽  
Brain Lesion ◽  
Stroke Patients ◽  
Lesion Effect ◽  
Linguistic Level

Six stroke patients were studied using a dichotic listening¹ CV task, 4 with left hemisphere infarction, 2 with right hemisphere infarction. It was observed a «lesion--effect», a shift of hemisphere prevalence to the side opposite a brain lesion. The authors suggest that the lesion-effect can be explained by the auditory extinction phenomenon at the linguistic level.

Assessing visual extinction in right-hemisphere stroke patients with and without neglect

2010 ◽  
Vol 41 (01) ◽  
Author(s):  
S Vossel ◽  
P Eschenbeck ◽  
P Weiss ◽  
G Fink
Keyword(s):  
Right Hemisphere ◽  
Stroke Patients ◽  
Visual Extinction ◽  
Right Hemisphere Stroke

Effect of Neuromuscular Electrical Stimulation on Swallowing Process in Stroke Patient with Neurogenic Dysphagia

1970 ◽  
Vol 1 (1) ◽  
pp. 44-53
Author(s):  
Ruth Ariyani ◽  
Widjajalaksmi ◽  
Luh K Wahyuni ◽  
Susyana Tamin ◽  
Saptawati Bardosono
Keyword(s):  
Electrical Stimulation ◽  
Voice Quality ◽  
Neuromuscular Electrical Stimulation ◽  
Neurogenic Dysphagia ◽  
Stroke Patients ◽  
Cough Reflex ◽  
Voluntary Cough ◽  
Pharyngeal Phase ◽  
Significant Difference ◽  
Quasi Experimental

Objective: The aim of this study to determine the therapeutic effect of Neuromuscular Electrical Stimulation (NMES) on pharyngeal phase of swallowing for stroke patients with neurogenic dysphagia,and to see the effect of NMES in reducing the incidence of standing secretion, residue, penetration and aspiration.Methods: It is a quasi-­experimental study design. 10 stroke patients with neurogenic dysphagia in Cipto Mangunkusumo hospital, Jakarta, 40-­80 years old with hemodynamically stable, cooperative and will be get NMES therapy for 4 weeks. Pre and Post treatment assessment caompared using a modified MASA test (The Mann Assessment of Swallowing Ability) and FEES examination (Flexible Endoscophic Evaluation of Swallowing). Analysis of change scores using Wilcoxon test.Results:The obtain average age of patients 59.80+9.705 years. Significant difference seen in the pharyngeal phase of swallowing increased score of gag reflex, velum elevation, cough reflex, voluntary cough, voice quality, pharynx response, pharyngeal constrictor contraction and vocal cord adduction (p<0.005).Also seen significant reduction in the incidence of standing secretion, residue and penetration (p<0.005), but not significantly in the incidence of aspiration (p=0083).Conclusions: NMES increased the pharyngeal phase of swallowing, reduced the incidence of standing secretion, residue and penetration of stroke patients with neurogenic dysphagia, but have not able to reduced aspiration.Keywords :Neuromuscular Electrical Stimulation (NEMS), neurogenic dysphagia, MASA test (The Mann Assessment of Swallow ing Ability), FEES examination (Flexible Endoscophic Evaluation of Swallowing), swallowing process.

scholarly journals Emotional Reactions to Music in Dementia Patients and Healthy Controls: Differential Responding Depends on the Mechanism

2021 ◽  
Vol 4 ◽  
pp. 205920432110101
Author(s):  
Gonçalo T. Barradas ◽  
Patrik N. Juslin ◽  
Sergi Bermúdez i Badia
Keyword(s):  
Episodic Memory ◽  
Brain Stem ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Basic Research ◽  
Brain Regions ◽  
Emotional Reactions ◽  
Dementia Patients ◽  
Significant Difference ◽  
Brain Stem Reflex

Music is frequently regarded as a unique way to connect with dementia patients. Yet little is known about how persons with dementia respond emotionally to music. Are their responses different from those of healthy listeners? If so, why? The present study makes a first attempt to tackle these issues in a Portuguese context, with a focus on psychological mechanisms. In Experiment 1, featuring 20 young and healthy adults, we found that musical excerpts which have previously been shown to activate specific emotion induction mechanisms (brain stem reflex, contagion, episodic memory, musical expectancy) in Sweden were valid and yielded predicted emotions also in Portugal, as indexed by self-reported feelings, psychophysiology, and post hoc mechanism indices. In Experiment 2, we used the same stimuli to compare the responses of 20 elderly listeners diagnosed with Alzheimer’s disease (AD) with those of 20 healthy listeners. We controlled for cognitive functioning (Mini-Mental State Examination) and depression (Geriatric Depression Scale). Our predictions about how mechanisms would be differentially affected by decline in brain regions associated with AD received support in that AD patients reported significantly lower levels of (a) sadness in the contagion condition, (b) happiness and nostalgia in the episodic memory condition, and (c) anxiety in the musical expectancy condition. By contrast, no significant difference in reported surprise was found in the brain stem reflex condition. Implications for musical interventions aimed at dementia are discussed, highlighting the key role that basic research may play in developing applications.

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 Are visual working memory and episodic memory distinct processes? Insight from stroke patients by lesion-symptom mapping

2021 ◽  
Author(s):  
Selma Lugtmeijer ◽  
◽  
Linda Geerligs ◽  
Frank Erik de Leeuw ◽  
Edward H. F. de Haan ◽  
...  
Keyword(s):  
Working Memory ◽  
Episodic Memory ◽  
Visual Working Memory ◽  
Visual Memory ◽  
Right Hemisphere ◽  
Memory Task ◽  
Stroke Patients ◽  
Lesion Symptom Mapping ◽  
Criterion Setting ◽  
The Right

AbstractWorking memory and episodic memory are two different processes, although the nature of their interrelationship is debated. As these processes are predominantly studied in isolation, it is unclear whether they crucially rely on different neural substrates. To obtain more insight in this, 81 adults with sub-acute ischemic stroke and 29 elderly controls were assessed on a visual working memory task, followed by a surprise subsequent memory test for the same stimuli. Multivariate, atlas- and track-based lesion-symptom mapping (LSM) analyses were performed to identify anatomical correlates of visual memory. Behavioral results gave moderate evidence for independence between discriminability in working memory and subsequent memory, and strong evidence for a correlation in response bias on the two tasks in stroke patients. LSM analyses suggested there might be independent regions associated with working memory and episodic memory. Lesions in the right arcuate fasciculus were more strongly associated with discriminability in working memory than in subsequent memory, while lesions in the frontal operculum in the right hemisphere were more strongly associated with criterion setting in subsequent memory. These findings support the view that some processes involved in working memory and episodic memory rely on separate mechanisms, while acknowledging that there might also be shared processes.

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