Impact of Cognitive Neuroscience on Stroke Rehabilitation

Clarke, Stéphanie; Bindschaedler, Claire; Crottaz-Herbette, Sonia

doi:10.1161/strokeaha.115.007435

Cited by 11 publications

(8 citation statements)

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“…There are, however, exceptions, which we discuss in detail in Section 5.4; rightward PA does not affect spatial bias in lateral preference tasks (Ferber et al, 2003;Sarri et al, 2011Sarri et al, , 2006, size estimation (Dijkerman et al, 2003), or visual search . Furthermore, several clinical studies reported promising, albeit not conclusive effects of rightward PA (Keane et al, 2006;Nys et al, 2008), possibly because not all types of neglect respond equally well to this treatment (Clarke et al, 2015).…”

Section: Unilateral Neglect: Alleviation Of the Spatial Attentional Dmentioning

confidence: 99%

Modulation of visual attention by prismatic adaptation

Clarke

Crottaz-Herbette

2016

Neuropsychologia

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Visuo-motor adaptation via rightward-deviating prisms has been repeatedly shown to alleviate lateralized deficits in neglect, including detection of targets as well as endogenous and exogenous orienting of attention. We review here evidence relevant to the underlying neural mechanisms. Rightward prismatic adaptation was shown to shift visual field representation from right to left inferior parietal lobule, changing thus hemispheric dominance within the ventral attentional system. This change is likely to redirect visual input to the dorsal attentional system and to re-install balance between its left- and right-hemispheric components in neglect. We propose a model based on the shift in hemispheric dominance within the ventral attentional system (SHD-VAS), which offers a parsimonious explanation for the effect of rightward prismatic adaptation on spatial bias in neglect and on behavioral data in normal subjects.

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Section: Unilateral Neglect: Alleviation Of the Spatial Attentional Dmentioning

confidence: 99%

Modulation of visual attention by prismatic adaptation

Clarke

Crottaz-Herbette

2016

Neuropsychologia

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“…We propose that the reshuffling of spatial representations within the left IPL renders the left-dominant attentional network (Rushworth et al, 2001(Rushworth et al, , 2003 and the left-dominant implicit representation of the auditory space (Tissieres et al, 2019) accessible to visual stimuli, creating thus an alternative visual space representation, which takes over the role of the damaged right-dominant VAN. The ensuing switch of dominance within VAN from the right to the left hemisphere has been described and commented upon in previous publications (Crottaz-Herbette et al, 2014Clarke et al, 2015;Clarke and Crottaz-Herbette, 2016;Tissieres et al, 2018).…”

Section: Rightward Prismatic Adaptationmentioning

confidence: 80%

Choosing Sides: Impact of Prismatic Adaptation on the Lateralization of the Attentional System

Clarke

Farron²,

Crottaz-Herbette³

2022

Front. Psychol.

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Seminal studies revealed differences between the effect of adaptation to left- vs. right-deviating prisms (L-PA, R-PA) in normal subjects. Whereas L-PA leads to neglect-like shift in attention, demonstrated in numerous visuo-spatial and cognitive tasks, R-PA has only minor effects in specific aspects of a few tasks. The paucity of R-PA effects in normal subjects contrasts with the striking alleviation of neglect symptoms in patients with right hemispheric lesions. Current evidence from activation studies in normal subjects highlights the contribution of regions involved in visuo-motor control during prism exposure and a reorganization of spatial representations within the ventral attentional network (VAN) after the adaptation. The latter depends on the orientation of prisms used. R-PA leads to enhancement of the ipsilateral visual and auditory space within the left inferior parietal lobule (IPL), switching thus the dominance of VAN from the right to the left hemisphere. L-PA leads to enhancement of the ipsilateral space in right IPL, emphasizing thus the right hemispheric dominance of VAN. Similar reshaping has been demonstrated in patients. We propose here a model, which offers a parsimonious explanation of the effect of L-PA and R-PA both in normal subjects and in patients with hemispheric lesions. The model posits that prismatic adaptation induces instability in the synaptic organization of the visuo-motor system, which spreads to the VAN. The effect is lateralized, depending on the side of prism deviation. Successful pointing with prisms implies reaching into the space contralateral, and not ipsilateral, to the direction of prism deviation. Thus, in the hemisphere contralateral to prism deviation, reach-related neural activity decreases, leading to instability of the synaptic organization, which induces a reshuffling of spatial representations in IPL. Although reshuffled spatial representations in IPL may be functionally relevant, they are most likely less efficient than regular representations and may thus cause partial dysfunction. The former explains, e.g., the alleviation of neglect symptoms after R-PA in patients with right hemispheric lesions, the latter the occurrence of neglect-like symptoms in normal subjects after L-PA. Thus, opting for R- vs. L-PA means choosing the side of major IPL reshuffling, which leads to its partial dysfunction in normal subjects and to recruitment of alternative or enhanced spatial representations in patients with hemispheric lesions.

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“…Somatosensory cortical responses can be measured using high-density EEG recordings and electrical neuroimaging in children with CP and do not require active participation, joint, or sustained attention. Neuroimaging can reveal treatment-relevant effects in brain structure and function [ 41 ], including in CP [ 42 ]. Traditional sensory and behavioral tests in stroke patients demonstrate that rehabilitation can lead to compensation using residual capacities (by the less affected limb or alternative muscle groups of the more affected side) [ 43 ] rather than to the recovery of lost/suppressed functions.…”

Section: Discussionmentioning

confidence: 99%

Somatosensory Plasticity in Pediatric Cerebral Palsy following Constraint-Induced Movement Therapy

et al. 2018

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Cerebral palsy (CP) is predominantly a disorder of movement, with evidence of sensory-motor dysfunction. CIMT1 is a widely used treatment for hemiplegic CP. However, effects of CIMT on somatosensory processing remain unclear. To examine potential CIMT-induced changes in cortical tactile processing, we designed a prospective study, during which 10 children with hemiplegic CP (5 to 8 years old) underwent an intensive one-week-long nonremovable hard-constraint CIMT. Before and directly after the treatment, we recorded their cortical event-related potential (ERP) responses to calibrated light touch (versus a control stimulus) at the more and less affected hand. To provide insights into the core neurophysiological deficits in light touch processing in CP as well as into the plasticity of this function following CIMT, we analyzed the ERPs within an electrical neuroimaging framework. After CIMT, brain areas governing the more affected hand responded to touch in configurations similar to those activated by the hemisphere controlling the less affected hand before CIMT. This was in contrast to the affected hand where configurations resembled those of the more affected hand before CIMT. Furthermore, dysfunctional patterns of brain activity, identified using hierarchical ERP cluster analyses, appeared reduced after CIMT in proportion with changes in sensory-motor measures (grip or pinch movements). These novel results suggest recovery of functional sensory activation as one possible mechanism underlying the effectiveness of intensive constraint-based therapy on motor functions in the more affected upper extremity in CP. However, maladaptive effects on the less affected constrained extremity may also have occurred. Our findings also highlight the use of electrical neuroimaging as feasible methodology to measure changes in tactile function after treatment even in young children, as it does not require active participation.

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Impact of Cognitive Neuroscience on Stroke Rehabilitation

Cited by 11 publications

References 100 publications

Modulation of visual attention by prismatic adaptation

Modulation of visual attention by prismatic adaptation

Choosing Sides: Impact of Prismatic Adaptation on the Lateralization of the Attentional System

Somatosensory Plasticity in Pediatric Cerebral Palsy following Constraint-Induced Movement Therapy

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