Investigating Usability of c-SIGHT in the Homes of Brain Injury Survivors With Spatial Neglect

Author(s):  
Keyword(s):  
PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245425
Author(s):  
Tomas Vilimovsky ◽  
Peii Chen ◽  
Kristyna Hoidekrova ◽  
Jakub Petioky ◽  
Pavel Harsa

Spatial neglect (SN) is a common cognitive disorder after brain injury. Prism adaptation treatment (PAT) is one of the promising interventions for SN albeit inconsistent results from previous studies. We carried out a comparison intervention (PAT vs. Sham) and aimed to evaluate the efficacy of PAT on visuospatial symptoms of SN in an inpatient rehabilitation setting that offered a highly intensive comprehensive brain injury rehabilitation program. A total of 34 patients with moderate-to-severe SN secondary to stroke or traumatic brain injury were randomized to the PAT group and the Sham group (an active control group). Both groups received 10 sessions of treatment, over two weeks, in addition to the rehabilitation therapies provided by their rehabilitation care teams. Outcomes were measured using an ecological instrument (the Catherine Bergego Scale) and paper-and-pencil tests (the Bells Test, the Line Bisection Test and the Scene Copying Test). Patients were assessed at baseline, immediately after treatment, two weeks after treatment, and four weeks after treatment. 23 (67.6%) patients completed treatment and all the assessment sessions and were included in the final analyses using mixed linear modeling. While SN symptoms reduced in both groups, we found no difference between the two groups in the degree of improvement. In addition, the average SN recovery rates were 39.1% and 28.6% in the PAT and Sham groups, respectively, but this discrepancy did not reach statistical significance. Thus, the present study suggests that PAT may contribute little to SN care in the context of a highly intensive inpatient rehabilitation program. Further large-scale investigation is required to uncover the mechanisms underlying PAT and Sham in order to refine the treatment or create new interventions.


2021 ◽  
Vol 2021 (7) ◽  
Author(s):  
Verity Longley ◽  
Christine Hazelton ◽  
Calvin Heal ◽  
Alex Pollock ◽  
Kate Woodward-Nutt ◽  
...  

1969 ◽  
Vol 34 (1) ◽  
pp. 82-86 ◽  
Author(s):  
Leonard L. La Pointe ◽  
Gerald L. Culton

2015 ◽  
Vol 30 (5) ◽  
pp. 451-460 ◽  
Author(s):  
Peii Chen ◽  
Irene Ward ◽  
Ummais Khan ◽  
Yan Liu ◽  
Kimberly Hreha

Background. Current knowledge about spatial neglect and its impact on rehabilitation mostly originates from stroke studies. Objective. To examine the impact of spatial neglect on rehabilitation outcome in individuals with traumatic brain injury (TBI). Methods. The retrospective study included 156 consecutive patients with TBI (73 women; median age = 69.5 years; interquartile range = 50-81 years) at an inpatient rehabilitation facility (IRF). We examined whether the presence of spatial neglect affected the Functional Independence Measure (FIM) scores, length of stay, or discharge disposition. Based on the available medical records, we also explored whether spatial neglect was associated with tactile sensation or muscle strength asymmetry in the extremities and whether specific brain injuries or lesions predicted spatial neglect. Results. In all, 30.1% (47 of 156) of the sample had spatial neglect. Sex, age, severity of TBI, or time postinjury did not differ between patients with and without spatial neglect. In comparison to patients without spatial neglect, patients with the disorder stayed in IRF 5 days longer, had lower FIM scores at discharge, improved slower in both Cognitive and Motor FIM scores, and might have less likelihood of return home. In addition, left-sided neglect was associated with asymmetric strength in the lower extremities, specifically left weaker than the right. Finally, brain injury–induced mass effect predicted left-sided neglect. Conclusions. Spatial neglect is common following TBI, impedes rehabilitation progress in both motor and cognitive domains, and prolongs length of stay. Future research is needed for linking specific traumatic injuries and lesioned networks to spatial neglect and related impairment.


Stroke ◽  
2021 ◽  
Vol 52 (9) ◽  
Author(s):  
Verity Longley ◽  
Christine Hazelton ◽  
Calvin Heal ◽  
Alex Pollock ◽  
Kate Woodward-Nutt ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Francesco Di Gregorio ◽  
Fabio La Porta ◽  
Giada Lullini ◽  
Emanuela Casanova ◽  
Valeria Petrone ◽  
...  

Left hemispatial neglect (LHSN) is a frequent and disabling condition affecting patients who suffered from traumatic brain injury (TBI). LHSN is a neuropsychological syndrome characterized clinically by difficulties in attending, responding, and consciously representing the right side of space. Despite its frequency, scientific evidence on effective treatments for this condition in TBI patients is still low. According to existing literature, we hypothesize that in TBI, LHSN is caused by an imbalance in inter-hemispheric activity due to hyperactivity of the left hemisphere, as observed in LHSN after right strokes. Thus, by inhibiting this left hyperactivity, repetitive Transcranial Magnetic Stimulation (rTMS) would have a rebalancing effect, reducing LHSN symptoms in TBI patients. We plan to test this hypothesis within a single-blind, randomized SHAM controlled trial in which TBI patients will receive inhibitory i-rTMS followed by cognitive treatment for 15 days. Neurophysiological and clinical measures will be collected before, afterward, and in the follow-up. This study will give the first empirical evidence about the efficacy of a novel approach to treating LHSN in TBI patients.Clinical Trial Registration:https://www.clinicaltrials.gov/ct2/show/NCT04573413?cond=Neglect%2C+Hemispatial&cntry=IT&city=Bologna&draw=2&rank=2, identifier: NCT04573413.


2020 ◽  
Author(s):  
Takatoshi Hara ◽  
Aturan Shanmugalingam ◽  
Amanda McIntyre ◽  
Amer M. Burhan

ABSTRACTBackgroundIn recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for stroke and traumatic brain injury (TBI) populations.MethodsAll English articles from the following sources were searched from inception up to December 31, 2018: PubMed, Scopus, CINAHL, Embase, PsycINFO and CENTRAL. Randomized and prospective controlled trials, including cross-over studies, were included for analysis. Studies with at least five individuals post stroke or TBI, whereby at least five sessions of NIBS were provided and used standardized neuropsychological measurement of cognition, were included.ResultsA total of 17 studies met eligibility criteria which included 546 patients receiving either repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS). Sample sizes ranged 5-25 subjects per group. Seven studies used rTMS and ten studies used tDCS. Target symptoms included global cognition (n=8), memory (n=1), attention (n=1), and unilateral spatial neglect (USN) (n=7). Nine studies combined rehabilitation or additional therapy with NIBS. Six of ten studies showed significant improvement in attention, memory, working memory, and executive function. In the USN study, five of the seven studies had a significant improvement in the intervention group.ConclusionsThe effect of NIBS on executive functions including attention and memory post stroke or TBI yielded mixed results with variable stimulation parameters. A significant, consistent improvement was observed for USN post stroke or TBI. Future studies using advanced neurophysiological and neuroimaging tools to allow network-based approach to NIBS for cognitive symptoms post stroke or TBI are warranted.


2019 ◽  
Vol 42 ◽  
Author(s):  
Colleen M. Kelley ◽  
Larry L. Jacoby

Abstract Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.


2019 ◽  
Vol 3 (6) ◽  
pp. 707-711 ◽  
Author(s):  
Andrew Peterson ◽  
Adrian M. Owen

In recent years, rapid technological developments in the field of neuroimaging have provided several new methods for revealing thoughts, actions and intentions based solely on the pattern of activity that is observed in the brain. In specialized centres, these methods are now being employed routinely to assess residual cognition, detect consciousness and even communicate with some behaviorally non-responsive patients who clinically appear to be comatose or in a vegetative state. In this article, we consider some of the ethical issues raised by these developments and the profound implications they have for clinical care, diagnosis, prognosis and medical-legal decision-making after severe brain injury.


Sign in / Sign up

Export Citation Format

Share Document