Explore the vast range of titles available.

Objective. To evaluate the use of different treatment systems to increase the efficacy of the rehabilitation of patients with neglect syndrome (NS) after stroke. Materials and methods. The effects of observing a protocol for managing patients with NS and using Ceraxon (citicoline) on the extent of recovery of neurological functions, the level of daily adaptation, and elimination of NS were studied in stroke patients. Treatment results from 120 patients were analyzed. The extent of restoration of functions was assessed using the Lindmark scale, the level of daily adaptation using the Barthel scale and the Merton and Sutton scale, the state of cognitive functions using the MMSE and the Frontal Assessment Battery, and psychoemotional status using the Beck questionnaire. Treatment efficacy was also evaluated in terms of the absence of the characteristic signs of NS. Results and conclusion. These studies showed that complex rehabilitation following the protocol for managing patients with NS and Ceraxon significantly increased rehabilitation efficacy in this group of patients.

Childhood adversity is associated with cognitive impairments in schizophrenia. However, findings to date are inconsistent and little is known about the relationship between social cognition and childhood trauma. We investigated the relationship between childhood abuse and neglect and cognitive function in patients with a first-episode of schizophrenia or schizophreniform disorder (n = 56) and matched healthy controls (n = 52). To the best of our knowledge, this is the first study assessing this relationship in patients and controls exposed to similarly high levels of trauma. Pearson correlational coefficients were used to assess correlations between Childhood Trauma Questionnaire abuse and neglect scores and cognition. For the MCCB domains displaying significant (p < 0.05) correlations, within group hierarchical linear regression, was done to assess whether abuse and neglect were significant predictors of cognition after controlling for the effect of education. Patients and controls reported similarly high levels of abuse and neglect. Cognitive performance was poorer for patients compared with controls for all cognitive domains except working memory and social cognition. After controlling for education, exposure to childhood neglect remained a significant predictor of impairment in social cognition in both patients and controls. Neglect was also a significant predictor of poorer verbal learning in patients and of attention/vigilance in controls. However, childhood abuse did not significantly predict cognitive impairments in either patients or controls. These findings are cross sectional and do not infer causality. Nonetheless, they indicate that associations between one type of childhood adversity (i.e. neglect) and social cognition are present and are not illness-specific.

•Connectivity in the visuospatial perceptual network (VPN) is impaired in Neglect.•Pre-stimulus alpha oscillatory activity is asymmetric and impaired in Neglect.•Post-stimulus N100 is impaired and delayed for right presented stimuli in Neglect.•Generative models show pre-and post-stimulus EEG relations in the VPN.•The model predicts visuospatial deficits and behavioral asymmetries in Neglect. Stroke patients with left Hemispatial Neglect (LHN) show deficits in perceiving left contralesional stimuli with biased visuospatial perception towards the right hemifield. However, very little is known about the functional organization of the visuospatial perceptual neural network and how this can account for the profound reorganization of space representation in LHN. In the present work, we aimed at (1) identifying EEG measures that discriminate LHN patients against controls and (2) devise a causative neurophysiological model between the discriminative EEG measures. To these aims, EEG was recorded during exposure to lateralized visual stimuli which allowed for pre-and post-stimulus activity investigation across three groups: LHN patients, lesioned controls, and healthy individuals. Moreover, all participants performed a standard behavioral test assessing the perceptual asymmetry index in detecting lateralized stimuli. The between-groups discriminative EEG patterns were entered into a Structural Equation Model for the identification of causative hierarchical associations (i.e., pathways) between EEG measures and the perceptual asymmetry index. The model identified two pathways. A first pathway showed that the combined contribution of pre-stimulus frontoparietal connectivity and individual-alpha-frequency predicts post-stimulus processing, as measured by visual-evoked N100, which, in turn, predicts the perceptual asymmetry index. A second pathway directly links the inter-hemispheric distribution of alpha-amplitude with the perceptual asymmetry index. The two pathways can collectively explain 83.1% of the variance in the perceptual asymmetry index. Using causative modeling, the present study identified how psychophysiological correlates of visuospatial perception are organized and predict the degree of behavioral asymmetry in LHN patients and controls.

Objective:The prism adaptation (PA) with rightward shifting lenses is a promising rehabilitation technique for left hemispatial neglect. The PA has also been applied in healthy individuals to investigate cognitive mechanism(s) underlining such adaptation. Importantly, studies have suggested that PA may primarily impact the functions of the dorsal or the ventral attentional stream, and we have previously reported that PA to the upward and downward shifting lenses leads to a significant aftereffect in vertical line bisection task. However, this post-adaptation effect, similarly to that seen in the horizontal plane, might have been modified by the presence of the vertical pseudoneglect healthy participants often experience prior to PA. Thus, the aim of this study was to test this hypothesis.Participants and Methods:30 right-handed healthy adults (age M=22,4) performed a computerized line bisection (LB) in vertical and horizontal condition. The bisections were performed twice: before and after PA procedure. Participants took experimental procedure three times, each in at least 24 h of break, each time in one of three conditions of shifting lenses; down, up, control. Both LB tasks (vertical and horizontal) consisted of 24 lines, each centered on 23\" touch screen. The participants were asked to find the middle of the line. Throughout the experiment, participants were comfortably seated with their head positioned on a chinrest. Participants were fitted with prismatic goggles that deviated their visual field by 10 degrees. For the adaptation we used the Peg-the-mole procedure consisting of 120 pointing movements.Results:To assess the effect of the vertical PA on landmark judgments we performed a repeated measures ANOVA with direction of PA (upward/downward), the condition of LB (vertical/ horizontal) and pre- vs post adaptation as a between-subjects factor. This analysis revealed a main effect of the direction of PA (p< 0.001) and a main effect of condition (p< 0.001). Overall, however, only adaptation in up-shifting lenses led to significant aftereffects (p<0.05). Further, when we excluded participants who did not exhibited horizontal pseudoneglect in preadaptation LB, the effect of PA in downshifting PA emerged in vertical LB (p<0.05). Further, this group also exhibited the aftereffect of PA in up-shifting lenses for the horizontal (p<0.01) and the vertical LB (p<0.05). Additionally, these participants exhibited a congruent tendency after upward and downward PA, and tended to allocate their attention more upward and rightward.Conclusions:The results of this study confirm that the vertical PA evokes a visuo-spatial bias. Moreover, the PA aftereffect seems to be modified by the presence of the pre-adaptation pseudoneglect. Whereas the mechanism inducing this bias is not fully known, it might be explained in light of the interhemispheric activation-inhibition balance. Both the upward and downward PA may primarily lead to activation of the posterior regions of the right hemisphere, and this activation may result with the upward and rightward bias in the LB task. However, future research with neuroimaging techniques is needed to test this hypothesis.

Acute brain ischemia causes changes in several neural networks and related cortico-subcortical excitability, both in the affected area and in the apparently spared contralateral hemisphere. The modulation of these processes through modern techniques of noninvasive brain stimulation, namely repetitive transcranial magnetic stimulation (rTMS), has been proposed as a viable intervention that could promote post-stroke clinical recovery and functional independence. This review provides a comprehensive summary of the current evidence from the literature on the efficacy of rTMS applied to different clinical and rehabilitative aspects of stroke patients. A total of 32 meta-analyses published until July 2019 were selected, focusing on the effects on motor function, manual dexterity, walking and balance, spasticity, dysphagia, aphasia, unilateral neglect, depression, and cognitive function after a stroke. Only conventional rTMS protocols were considered in this review, and meta-analyses focusing on theta burst stimulation only were excluded. Overall, both HF-rTMS and LF-rTMS have been shown to be safe and well-tolerated. In addition, the current literature converges on the positive effect of rTMS in the rehabilitation of all clinical manifestations of stroke, except for spasticity and cognitive impairment, where definitive evidence of efficacy cannot be drawn. However, routine use of a specific paradigm of stimulation cannot be recommended yet due to a significant level of heterogeneity of the studies in terms of protocols to be set and outcome measures that have to be used. Future studies need to preliminarily evaluate the most promising protocols before going on to multicenter studies with large cohorts of patients in order to achieve a definitive translation into daily clinical practice.

Unilateral Spatial Neglect is a disabling neuropsychological deficit. Patients with spatial neglect fail to detect and report events, and to perform actions in the side of space contralateral to a hemispheric cerebral lesion. Neglect is assessed by evaluating the patients’ abilities in daily life activities and by psychometric tests. Computer-based, portable and Virtual Reality technologies may provide more and precise data, and be more sensitive and informative, compared to current paper-and-pencil procedures. Studies since 2010, in which such technologies have been used, are reviewed. Forty-two articles meeting inclusion criteria are categorized according to their technological approaches (computer-, graphics tablet or tablet-, virtual reality-based assessment, and other). The results are promising. However, a definite golden standard, technologically based procedure cannot be still established. Developing technologically based tests is a laborious process, which requires technical and user experience improvements as well as normative data, to increase the evidence of efficacy for clinical evaluation of at least some of the tests considered in this review.

To capture the distortion of exploratory activity typical of patients with spatial neglect, traditional diagnostic methods and new virtual reality applications use confined workspaces that limit patients' exploration behavior to a predefined area. Our aim was to overcome these limitations and enable the recording of patients' biased activity in real, unconfined space. We developed the Free Exploration Test (FET) based on augmented reality technology. Using a live stream via the back camera on a tablet, patients search for a (non-existent) virtual target in their environment, while their exploration movements are recorded for 30 s. We tested 20 neglect patients and 20 healthy participants and compared the performance of the FET with traditional neglect tests. In contrast to controls, neglect patients exhibited a significant rightward bias in exploratory movements. The FET had a high discriminative power (area under the curve = 0.89) and correlated positively with traditional tests of spatial neglect (Letter Cancellation, Bells Test, Copying Task, Line Bisection). An optimal cut-off point of the averaged bias of exploratory activity was at 9.0° on the right; it distinguished neglect patients from controls with 85% sensitivity. FET offers time-efficient (execution time: ∼3 min), easy-to-apply, and gamified assessment of free exploratory activity. It supplements traditional neglect tests, providing unrestricted recording of exploration in the real, unconfined space surrounding the patient.

ObjectiveAlthough post-stroke cognitive deficit can significantly limit patient independence and social re-integration, clinical routine predictors for this condition are lacking. ‘Cognitive reserve’ limits the detrimental effects of slowly developing neurodegeneration. We aimed to determine whether comparable effects also exist in acute stroke. Using 'years of education' as a proxy, we investigated whether cognitive reserve beneficially influences cognitive performance and disability after stroke, whilst controlling for age and lesion size as measure of stroke pathology.MethodsWithin the first week of ischemic right hemisphere stroke, 36 patients were assessed for alertness, working memory, executive functions, spatial neglect, global cognition and motor deficit at 4.9 ± 2.1 days post-stroke, in addition to routine clinical tests (NIH Stroke Scale, modified Rankin Scale on admission < 24 h post-stroke and at discharge 9.5 ± 4.7 days post-stroke). The impact of education was assessed using partial correlation analysis adjusted for lesion size, age, and the time interval between stroke and assessment. To validate our results, we compared groups with similar age and lesion load, but different education levels.ResultsIn the acute stroke phase, years of education predicted both severity of education independent (alertness) and education dependent (working memory, executive functions, global cognition) cognitive deficits and disability (modified Rankin Scale). Spatial neglect seemed to be independent.InterpretationProxies of cognitive reserve should be considered in stroke research as early as in the acute stroke phase. Cognitive reserve contributes to inter-individual variability in the initial severity of cognitive deficits and disability in acute stroke, and may suggest individualised rehabilitation strategies.

A review of patients with brain injury showing personal neglect is presented. The aim is to shed light on this aspect of neglect often unresearched or only indirectly investigated, and to discuss recent findings concerning the methods used to assess personal neglect, its neural correlates and its association with the more often explored aspect of extrapersonal neglect. The review was performed using PubMed and PsychInfo databases to search for papers published in the last 123 years (until January 2018). We reviewed 81 papers describing either single or group studies for a total of 2247 patients. The results of this review showed that various aspects of personal neglect are still controversial and outcomes potentially contradictory. Despite the data reported in the present review suggest that personal neglect is more frequently associated with lesions of the right hemisphere, the left hemisphere may also play an important role. Not surprisingly, personal neglect and extrapersonal neglect seem to co-occur. However double dissociations of these two forms of neglect have been reported, and they seem to dissociate both from a functional and an anatomical perspective. More recent interpretations of personal neglect suggest that it may result from a disrupted body representation. The development of reliable psychometric tools with shared diagnostic criteria is essential to identify different degrees of personal neglect for different body parts and to better refine personal neglect in comparison to extrapersonal neglect and disorders related to distortions of personal domain.

Socioeconomic segregation has an important role in the emergence of large-scale inequalities in urban areas. Most of the available measures of spatial segregation depend on the scale and size of the system under study, or neglect large-scale spatial correlations, or rely on ad-hoc parameters, making it hard to compare different systems on equal grounds. We propose here a family of non-parametric measures for spatial distributions, based on the statistics of the trajectories of random walks on graphs associated to a spatial system. These quantities provide a consistent estimation of segregation in synthetic spatial patterns, and we use them to analyse the ethnic segregation of metropolitan areas in the US and the UK. We show that the spatial diversity of ethnic distributions, as measured through diffusion on graphs, allow us to compare the ethnic segregation of urban areas having different size, shape, or peculiar microscopic characteristics, and exhibits a strong association with socio-economic deprivation. Socioeconomic segregation is one of the main factors behind large-scale inequalities in urban areas and its characterisation remains challenging. The authors propose a family of non-parametric measures to quantify spatial heterogeneity through diffusion, and show how this relates to segregation and deprivation