The human brain is constantly bombarded with both external and internal sensory stimulation.Efficient registration and modulation of this sensory stimulation allows us to adapt our behavior to the continuous changes in the environment which is fundamental to human cognition. Acquired brain injury can affect sensory processing resulting in an atypical response to sensory stimulation
Background: Although subjective sensory hypersensitivity is prevalent after stroke, it is rarely recognized by health care providers, and its neural mechanisms are largely unknown. Objective: To investigate the neuroanatomy of poststroke subjective sensory hypersensitivity as well as the sensory modalities in which subjective sensory hypersensitivity can occur by conducting both a systematic literature review and a multiple case study of patients with subjective sensory hypersensitivity. Method: For the systematic review, we searched three databases (Web of Science, PubMed, and Scopus) for empirical articles discussing the neuroanatomy of poststroke subjective sensory hypersensitivity in humans. We assessed the methodological quality of the included studies using the case reports critical appraisal tool and summarized the results using a qualitative synthesis. For the multiple case study, we administered a patient-friendly sensory sensitivity questionnaire to three individuals with a subacute right-hemispheric stroke and a matched control group and delineated brain lesions on a clinical brain scan. Results: Our systematic literature search resulted in four studies (describing eight stroke patients), all of which linked poststroke subjective sensory hypersensitivity to insular lesions. The results of our multiple case study indicated that all three stroke patients reported an atypically high sensitivity to different sensory modalities. These patients’ lesions overlapped with the right anterior insula, the claustrum, and the Rolandic operculum. Conclusion: Both our systematic literature review and our multiple case study provide preliminary evidence for a role of the insula in poststroke subjective sensory hypersensitivity and suggest that poststroke subjective sensory hypersensitivity can occur in different sensory modalities.
Many activities in daily life rely on the ability to continuously keep attention on task requirements. Patients with acquired brain injury often suffer from deficits in sustained attention that impact quality of life and complicate rehabilitation. The sustained attention to response task (SART) is a commonly used go/no-go task in the assessment of sustained attention. However, its feasibility for patients with acquired brain injury could be questioned considering deficits in alphanumerical processing following brain damage. We investigated whether a SART with sinusoidal gratings instead of digits can be used to assess sustained attention. The Gratings SART and Digits SART were administered in a random and fixed sequence to 48 cognitively healthy participants. Performance of the neurotypical individuals on the random and fixed Gratings SART was only moderately different from and correlated with performance on the random and fixed Digits SART. As a proof of concept, the SARTs were also administered to 11 cases with acquired brain injury. Performance in the random and fixed variants of both the Gratings SART and Digits SART was sensitive to cognitive impairments of cases with acquired brain injury. In conclusion, the SART with sinusoidal gratings holds promise as a tool to (re-)assess sustained attention in clinical practice.Further research is critical to investigate whether its performance accurately predicts sustained attention in daily life since we failed to find a significant correlation between performance on any of the SARTs and a self-reported measure of sustained attention.
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