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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The trial of a treatment device for Unilateral Spatial Neglect (USN) is reported. A patient who had suffered a right hemisphere stroke that resulted in left sided neglect was studied over a six month period. The study involved the use of a customized electrical device providing stimulation to the neglected hand, triggered by movement of the unaffected side. A battery of neglect measures were performed regularly throughout the study period. Though the results were difficult to interpret, there was no conclusive evidence that the device was effective. The possible reasons for this, the methodological difficulties inherent in studies of this type and suggestions for further studies are discussed.
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PMID:Use of a novel contingency stimulator in Unilateral Spatial Neglect. 1145 84

Prose reading has been shown to be a very sensitive measure of Unilateral Spatial Neglect. However, little is known about the relationship between prose reading and other measures of neglect and its severity, or between prose reading and single word reading. Thirty participants with a first stroke in the right hemisphere and clear symptoms of spatial neglect in everyday life were assessed with tests of prose reading (text in one column book-like, and in two columns magazine-like), single words reading, and a battery of 13 tests investigating neglect. Seventy percent of these participants omitted words at the beginning of the text (left end), showing Prose Reading Neglect (PRN). The participants showing PRN differed from those not showing PRN only for the overall severity of neglect, and had a lesion centred on the insula, putamen and superior temporal gyrus. Double dissociations emerged between PRN and single word reading neglect, suggesting different cognitive requirements between the two tests: parallel processing in single word reading vs. serial analysis in text reading. Notably, the pattern of neglected text varied dramatically across participants presenting with PRN, including dissociations between reading performance of one and two columns text. Prose reading proved a complex and unique task which should be directly investigated to predict the effects of unilateral neglect. The outcome of this study should also inform clinical assessment and advises given to patients and care-givers.
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PMID:Prose reading in neglect. 2432 Nov 97

After experiencing a stroke in the right hemisphere, almost 50% of patients showed Unilateral Spatial Neglect (USN). In recent decades, Virtual Reality (VR) has been used as an effective tool both for the assessment and rehabilitation of USN. Indeed, this advanced technology allows post-stroke patients to interact with ecological and engaging environments similar to real ones, but in a safe and controlled way. To provide an overview of the most recent VR applications for the assessment and rehabilitation of USN, a systematic review has been carried out. Since 2010, 13 studies have proposed and tested innovative VR tools for USN. After a wide description of the selected studies, we discuss the main features of these VR tools in order to provide crucial indications for future studies, neurorehabilitation interventions, and clinical practice.
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PMID:Assessment and rehabilitation of neglect using virtual reality: a systematic review. 2637 19

Unilateral Spatial Neglect, the most dramatic manifestation of contralesional space unawareness, is a highly heterogeneous syndrome. The presence of neglect is related to core spatially lateralized deficits, but its severity is also modulated by several domain-general factors (such as alertness or sustained attention) and by task demands. We previously showed that a computer-based dual-task paradigm exploiting both lateralized and non-lateralized factors (i.e., attentional load/multitasking) better captures this complex scenario and exacerbates deficits for the contralesional space after right hemisphere damage. Here we asked whether multitasking would reveal contralesional spatial disorders in chronic left-hemisphere damaged (LHD) stroke patients, a population in which impaired spatial processing is thought to be uncommon. Ten consecutive LHD patients with no signs of right-sided neglect at standard neuropsychological testing performed a computerized spatial monitoring task with and without concurrent secondary tasks (i.e., multitasking). Severe contralesional (right) space unawareness emerged in most patients under attentional load in both the visual and auditory modalities. Multitasking affected the detection of contralesional stimuli both when presented concurrently with an ipsilesional one (i.e., extinction for bilateral targets) and when presented in isolation (i.e., left neglect for right-sided targets). No spatial bias emerged in a control group of healthy elderly participants, who performed at ceiling, as well as in a second control group composed of patients with Mild Cognitive Impairment. We conclude that the pathological spatial asymmetry in LHD patients cannot be attributed to a global reduction of cognitive resources but it is the consequence of unilateral brain damage. Clinical and theoretical implications of the load-dependent lack of awareness for contralesional hemispace following LHD are discussed.
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PMID:Multi-tasking uncovers right spatial neglect and extinction in chronic left-hemisphere stroke patients. 2694 71

The objective of this study was to examine visual scanning performance in patients with Unilateral Spatial Neglect (USN) in a visual search task. Thirty-one right hemisphere stroke patients with USN were recruited. They performed a dynamic visual search task with two conditions, with and without distractors, while eye movements were monitored with an eye-tracker. The main goal of the task was to select target stimuli that appeared from the top of the screen and moved vertically downward. Target detection and visual scanning percentage were assessed over two hemispaces (right, left) on two conditions (distractor, no distractor). Most Scanned Regions (MSR) were calculated to analyze the areas of the screen where most points of fixation were directed to. Higher target detection rate and visual scanning percentages were found on the right hemispace on both conditions. From the MSRs we found that participants with a center of attention further to the right of the screen also presented smaller overall MSRs. Right hemisphere stroke patients with USN presented not only a significant rightward bias but reduced overall search areas, implying hyperattention does not only restrict search on the horizontal (right-left) axis but the vertical axis (top-bottom) too.
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PMID:Visual search in unilateral spatial neglect: The effects of distractors on a dynamic visual search task. 2946 19