Hyperschematia after right brain damage: a meaningful entity?

Abstract

In recent years we reported three right-brain-damaged patients, who exhibited a left-sided disprortionate expansion of drawings, both by copying and from memory, contralateral to the side of the hemispheric lesion (Neurology, 67: 1801, 2006, Neurocase 14: 369, 2008). We proposed the term “hyperschematia” for such an expansion, with reference to an interpretation in terms of a lateral leftward distortion of the representation of extra-personal space, with a leftward anisometric expansion (relaxation) of the spatial medium. The symptom-complex shown by right-brain-damaged patients with “hyperschematia” includes: (1) a disproportionate leftward expansion of drawings (with possible addition of details), by copy and from memory (also in clay modeling, in one patient); (2) an overestimation of left lateral extent, when a leftward movement is required, associated in some patients with a perceptual underestimation; (3) unawareness of the disorder; (4) no unilateral spatial neglect. In most right-brain-damaged patients, left “hyperschematia” involves extra-personal space. In one patient the deficit was confined to a body part (left half-face: personal “hyperschematia”). The neural underpinnings of the disorder include damage to the fronto-temporo-parietal cortices, and subcortical structures in the right cerebral hemisphere, in the vascular territory of the middle cerebral artery. Here, four novel additional patients are reported. Finally, “hypeschematia” is reconsidered, in its clinical components, the underlying pathological mechanisms, as well as its neural underpinnings.

The Affective Neuroscience of Aging

“…Likewise, younger and older adults showed similar amygdala activation in response to high arousal negative stimuli but for low arousal negative stimuli older adults showed decreased amygdala activity compared with younger adults, along with increased activity in the anterior cingulate cortex (Dolcos et al, 2014). Greater anterior cingulate cortex activity was associated with less negative ratings of low arousal negative pictures for older but not for younger adults (see also Ge et al, 2014 for similar links between vmPFC/anterior cingulate activity and rating intensity). Thus, across studies, older adults’ memory, ratings, and amygdala activity resembles that of younger adults more when stimuli arousal is high than low.…”

“…Furthermore, it is relatively more responsive to positive than negative stimuli in older adults compared with younger adults (Erk et al, 2008, Ge et al, 2014, Kehoe et al, 2013, Leclerc and Kensinger, 2011, Mather et al, 2004, Waldinger et al, 2011, but see Moriguchi et al, 2011 for no age-by-valence effects in amygdala). Thus, the amygdala does not stop responding to emotional stimuli in later life, but instead, shifts which valence it is most responsive to.…”

“…Consistent with this, in a study that examined the relationship of anxiety to amygdala-ventral PFC in those aged 19–85 (with connectivity assessed for all of ventral PFC rather than just the uncinate fasciculus), better white matter structural integrity of the amygdala-ventral PFC pathway was not associated with lower anxiety either across the whole group or when age was accounted for (Clewett et al, 2014). One interesting possibility is that amygdala-vmPFC structural connectivity may be used to promote negative emotional processing among younger adults but positive emotional processing among older adults (Ford and Kensinger, 2014). …”

Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD

“…This recognition of the potential impact of VR technology has led to the emergence of a significant, albeit still maturing, research literature that documents the many clinical and research targets where VR can add value relative to traditional assessment and intervention methods. A short list of the areas where Clinical VR has been usefully applied includes fear reduction in persons with specific phobias (Morina et al, 2015; Opris et al, 2012; Parsons & Rizzo, 2008; Powers & Emmelkamp, 2008), treatment for posttraumatic stress disorder (Beidel, Frueh, Neer, & Lejuez, 2017; Botella et al, 2015; Difede & Hoffman, 2002; Difede et al, 2007, 2014; Maples-Keller et al, 2017; McLay et al, 2011; Rizzo et al, 2010, 2013, 2017; Rothbaum, Hodges, Ready, Graap, & Alarcon, 2001; Rothbaum et al, 2014), cue-exposure for addiction and relapse prevention (Hone-Blanchet, Wensing, & Fecteau, 2014; Yoon et al, 2014), depression (Falconer et al, 2016), paranoid delusions (Freeman et al, 2016), discomfort reduction in cancer patients undergoing chemotherapy (Schneider, Kisby, & Flint, 2010), acute pain reduction during wound care and physical therapy with burn patients (Hoffman et al, 2011), other painful procedures (Gold et al, 2006; Mosadeghi, Reid, Martinez, Rosen, & Spiegel, 2016), body image disturbances in patients with eating disorders (Riva, 2011), navigation and spatial training in children and adults with motor impairments (John, Pop, Day, Ritsos, & Headleand, 2017), functional skill training and motor rehabilitation in patients with central nervous system dysfunction (e.g. stroke, traumatic brain injury, spinal cord injury, cerebral palsy, multiple sclerosis, etc.)…”

A voxel-wise encoding model for early visual areas decodes mental images of remembered scenes

“…The recent MVPC studies have shown that patterns of activity generated during mental imagery in V1 and V2 are discriminable; specifically, pattern classifiers that accurately discriminate patterns of activity generated during perception of simple external stimuli can also discriminate patterns of activity generated during mental imagery of the same stimuli. MVPC studies that targeted high-order visual areas have shown similarity between activity patterns in those visual areas as well (Stokes et al, 2009; Reddy et al, 2010, Johnson and Johnson, 2014). Results from MVPC studies investigating visual working memory (Harrison and Tong, 2009; Xing et al, 2013), and dreaming (Horikawa et al, 2013) also support the notion that patterns of activity generated during mental imagery and perception are similar in some way.…”