Functional reorganisation in patients with right hemisphere stroke after training of alertness: a longitudinal PET and fMRI study in eight cases

Sturm, Walter; Longoni, Francesca; Weis, Susanne; Specht, Karsten; Herzog, Hans; Vohn, René; Thimm, Markus; Willmes, Klaus

doi:10.1016/j.neuropsychologia.2003.09.001

Cited by 55 publications

(35 citation statements)

References 31 publications

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“…The improvement in cognitive functions observed in the SG, most evident in the attentional and mnestic domains, could be explained on the basis of the "retraining" approach used in this study. The retraining method is in fact based on the assumption that a "target process" can be enhanced by repetitive stimulation, in the form of frequently practiced exercises for example (Petersen et al, 1998); such repetition is thought to make the skill more automatic and might induce a restitution of function in the brain, through modification of synaptic connectivity (Sturm et al, 2004;Kim et al, 2009). Rehabilitation in mild cognitive impairment is usually based on the retraining method, which demonstrates positive effects particularly in the domain of attention, as seen in the patients observed in this study; instead, when deficits are more severe, the teaching of compensatory strategies seems to be more suitable (Robertson and Murre, 1999).…”

Section: Discussionmentioning

confidence: 99%

Assessing and restoring cognitive functions early after stroke

Zucchella

Capone

Codella

et al. 2014

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SummaryCognitive impairment is a frequent complication of stroke. The aim of this study was to evaluate the effectiveness of cognitive training performed early after stroke. Ninety-two patients were randomly assigned to either the study group (SG) or the control group (CG). Cognitive rehabilitation consisted of 16 individual one-hour sessions in which patients performed therapist-guided computer exercises. The patients in the CG performed a sham intervention. After four weeks all the patients were re-evaluated. In the SG, significant improvements (p<0.05) were detected in all neuropsychological measures at the post-training evaluation, while the CG showed mild (not statistically significant) improvements on cognitive tests. Between-group analysis revealed statistiAssessing and restoring cognitive functions early after stroke cally significant differences in the domains of memory and visual attention. Cognitive training performed early after stroke seems to be a viable option for improving cognitive outcome in stroke survivors. Further studies should assess whether this may favor their reintegration into everyday life.

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Section: Discussionmentioning

confidence: 99%

Assessing and restoring cognitive functions early after stroke

Zucchella

Capone

Codella

et al. 2014

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“…First, the demonstration of a "topdown" cognitive route to reducing neglect through increases in alertness supports the arguments outlined by Robertson and colleagues (1995) and suggests that training in selfmaintaining an alert state has at least the potential to produce benefits. While it may be argued that patients are no more likely to remember to "alert themselves" than they are to remind themselves to look to the left over the long-term (Parton et al, 2004), it is possible that early rehabilitation may be sufficient to boot-strap levels of alertness that will then tend to be maintained by, for example, increased engagement with other activities (see Sturm et al, 2004). A second approach lies in the use of stimulant medication.…”

Section: Discussionmentioning

confidence: 99%

A demonstration of endogenous modulation of unilateral spatial neglect: The impact of apparent time-pressure on spatial bias

George

Mercer

Walker

et al. 2007

J Int Neuropsychol Soc

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Unilateral neglect, a lack of awareness for one side of space, is a common and debilitating consequence of stroke. Previous work has identified a relationship between enduring left neglect and diminished general alertness and shown that increasing alertness can temporarily reduce the severity of the spatial bias. In that research, alertness was modulated by loud tones or with pharmacological stimulants. Here we examine whether cognitive, endogenously driven changes can produce similar short-term improvements. Time-pressure is associated with increased subjective arousal and increased activation in cortical regions associated with alertness. Here five patients completed a spatial cancellation task with and without instructions regarding a time limit. Significant reductions in neglect severity were observed when patients believed that they were acting under time-pressure, despite the conditions being equivalent in the actual (unlimited) time available. Functional imaging work has highlighted the secondary effects that damage to networks mediating alertness can have on structurally intact spatial systems. The results here suggest that activation of presumably spared function in these damaged networks can induce moment-by-moment changes in spatial function and, crucially, that this can be achieved using entirely endogenous means. (JINS, 2008, 14, 33-41.)

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“…beginning to appear, and a very small number of studies 34,35,97 have investigated the impact of cognitive training and performance improvement on functional activations in clinical groups. The results of these studies suggest that rehabilitative training of cognitive function can restore and even normalize activation.…”

Section: S25 Normal Plasticity and Neurorehabilitation Kellymentioning

confidence: 99%

“…Working with cases of brain damage rather than dysfunction, Sturm et al 34 examined training-induced changes in functional activation in patients with right-hemisphere vascular damage. These stroke patients initially displayed impaired attentional functioning.…”

Section: S25 Normal Plasticity and Neurorehabilitation Kellymentioning

confidence: 99%

Patterns of Normal Human Brain Plasticity After Practice and Their Implications for Neurorehabilitation

Kelly

Foxe

Garavan

2006

Archives of Physical Medicine and Rehabilitation

115

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ABSTRACT. Kelly C, Foxe JJ, Garavan H. Patterns of normal human brain plasticity after practice and their implications for neurorehabilitation. Arch Phys Med Rehabil 2006;87(12 Suppl 2):S20-9.Objectives: To illustrate how our knowledge about normal patterns of experience-induced plasticity can provide insights into the mechanisms of neurorehabilitation; to provide an overview of the practice-effects literature in order to simplify and amalgamate a large number of heterogeneous findings and identify typical patterns of practice effects and their determining factors; and to concentrate on the impact of practice on higher cognitive functions, such as working memory, and present some preliminary but promising behavioral data that show how practice on a complex cognitive task can benefit cognitive functioning more generally.Data Sources: We performed a systematic search for peerreviewed journal articles using computerized databases (PubMed, ISI Web of Science, PsycINFO).Data Selection: Neuroimaging studies using functional magnetic resonance imaging (fMRI) or positron-emission tomography (PET) to examine functional activation changes as a result of practice on sensory, motor, or cognitive tasks in normal (healthy) populations were included in the review. Further studies were identified that examined the effects of rehabilitative training on functional activations in clinical populations using fMRI or PET.Data Extraction: Important characteristics of the selected studies were summarized in a systematic manner so to enable the extraction of specific factors impacting on the pattern of practice effects observed.Data Synthesis: We identified a number of factors that impact on the patterns of practice effects observed and discuss how the insights gained from the study of healthy populations can by applied to rehabilitation of cognitive deficits in clinical populations.Conclusions: Progress in our understanding of neurorehabilitative plasticity will be enabled by neuroimaging examinations of cognitive rehabilitation training grounded in a knowledge of normal (healthy) patterns of brain activation and practice-induced plasticity.Key Words: Neuronal plasticity; Rehabilitation. © 2006 by the American Congress of Rehabilitation MedicineT HE DISCOVERY THAT experience-driven changes in the human brain can occur from a synaptic to a cortical level throughout the life span has been termed a nascent revolution in cognitive neuroscience, 1 overthrowing the long-held belief that the adult brain is hard-wired and resistant to change. 2Research with both animal models and humans has shown that the organization of the adult cerebral cortex can change substantially as a result of practice and experience.3,4 Furthermore, experience-dependent change can occur at multiple levels of the central nervous system, from the molecular or synaptic level to the level of cortical maps and large-scale neural networks.2 These discoveries challenge us to investigate how it is that the brain changes in response to experience. Moreover, if the neuroanatom...

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Functional reorganisation in patients with right hemisphere stroke after training of alertness: a longitudinal PET and fMRI study in eight cases

Cited by 55 publications

References 31 publications

Assessing and restoring cognitive functions early after stroke

Assessing and restoring cognitive functions early after stroke

A demonstration of endogenous modulation of unilateral spatial neglect: The impact of apparent time-pressure on spatial bias

Patterns of Normal Human Brain Plasticity After Practice and Their Implications for Neurorehabilitation

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