Increase of frontal neuronal activity in chronic neglect after training in virtual reality

Ekman, Urban; Fordell, Helena; Eriksson, Johan; Lenfeldt, Niklas; Wåhlin, Anders; Eklund, Anders; Malm, Jan

doi:10.1111/ane.12955

Cited by 31 publications

(44 citation statements)

References 33 publications

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“…Previous studies also showed that VR could improve movement and body position perception [28]. In chronic neuropathic pain, a VR-based treatment could induce analgesia in association with an improved embodiment sensation [60].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of virtual reality to reduce chronic low back pain: Proof-of-concept of a non-pharmacological approach on pain, quality of life, neuropsychological and functional outcome

et al. 2019

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Objectives Chronic pain, such as low-back pain, can be a highly disabling condition degrading people’s quality of life (QoL). Not every patient responds to pharmacological therapies, thus alternative treatments have to be developed. The chronicity of pain can lead to a somatic dysperception, meaning a mismatch between patients’ own body perception and its actual physical state. Since clinical evaluation of pain relies on patients’ subjective reports, a body image disruption can be associated with an incorrect pain rating inducing incorrect treatment and a possible risk of drug abuse. Our aim was to reduce chronic low-back pain through a multimodal neurorehabilitative strategy using innovative technologies to help patients regain a correct body image. Methods Twenty patients with chronic low-back pain were included. Before and after treatment, patients underwent: a neurological exam; a neuro-psychological evaluation testing cognitive functions (memory, attention, executive functions) and personality traits, QoL and mood; pain ratings; sensorimotor functional abilities’ testing. Patients underwent a 6 week-neurorehabilitative treatment (total 12 sessions) using virtual reality (VRRS system, Khymeia, Italy). Treatment consisted on teaching patients to execute correct movements with the painful body parts to regain a correct body image, based on the augmented multisensory feedback (auditory, visual) provided by the VRRS. Results Our data showed significant reductions in all pain rating scale scores (p<0.05); significant improvements of QoL in the domains of physical functioning, physical role functioning, bodily pain, vitality, and social role functioning; improvements in cognitive functions (p<0.05); improvements in functional scales (p<0.05) and mood (p = 0.04). Conclusion This non-pharmacological approach was able to act on the multi-dimensional aspects of pain and improved patients’ QoL, pain intensity, mood and patient’s functional abilities.

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Section: Discussionmentioning

confidence: 99%

Efficacy of virtual reality to reduce chronic low back pain: Proof-of-concept of a non-pharmacological approach on pain, quality of life, neuropsychological and functional outcome

et al. 2019

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“…142 Interestingly, 2 years later, authors used fMRI to evaluate changes in brain activity during Posner′s Cueing Task after RehAtt™ rehabilitation. The amelioration of neglect symptoms was associated with increased brain activity in the pre-frontal and temporal cortex during attentional cueing, 143 suggesting enhancement of topdown strategies, and increased inter-hemispheric restingstate functional connectivity of the dorsal attentional network. 144 A final promising protocol was tested in a single-blind dose-response study in healthy subjects, by using VR as an alternative to real prisms.…”

Section: Virtual Realitymentioning

confidence: 92%

<p>Unilateral Spatial Neglect After Stroke: Current Insights</p>

Gammeri¹,

Iacono²,

Ricci

et al. 2020

NDT

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Introduction: Unilateral spatial neglect (USN) is a disorder of contralesional space awareness which often follows unilateral brain lesion. Since USN impairs awareness of contralesional space/body and often of concomitant motor disorders, its presence represents a negative prognostic factor of functional recovery. Thus, the disorder needs to be carefully diagnosed and treated. Here, we attempted to present a clear and concise picture of current insights in the comprehension and rehabilitation of USN. Methods: We first provided an updated overview of USN clinical and neuroanatomical features and then highlighted recent progresses in the diagnosis and rehabilitation of the disease. In relation to USN rehabilitation, we conducted a MEDLINE literature research on three of the most promising interventions for USN rehabilitation: prismatic adaptation (PA), non-invasive brain stimulation (NIBS), and virtual reality (VR). The identified studies were classified according to the strength of their methods. Results: The last years have witnessed a relative decrement of interest in the study of neuropsychological disorders of spatial awareness in USN, but a relative increase in the study of potential interventions for its rehabilitation. Although optimal protocols still need to be defined, high-quality studies have demonstrated the efficacy of PA, TMS and tDCS interventions for the treatment of USN. In addition, preliminary investigations are suggesting the potentials of GVS and VR approaches for USN rehabilitation. Conclusion: Advancing neuropsychological and neuroscience tools to investigate USN pathophysiology is a necessary step to identify effective rehabilitation treatments and to foster our understanding of neurofunctional bases of spatial cognition in the healthy brain.

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“…Neuroplasticity: the App permits to use scenarios specifically designed following principles that regulate and facilitate neuroplasticity (the neurobiological process basis of recovery of cognitive and motor functions), such as exercise intensity, exercise frequency, “enriched stimulation” ( Cheung et al, 2014 ; Ekman et al, 2018 ).…”

Section: Methodsmentioning

confidence: 99%

Assessment of Unilateral Spatial Neglect Using a Free Mobile Application for Italian Clinicians

et al. 2018

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Background: Unilateral Spatial Neglect (USN) is traditionally assessed with paper-and-pencil tests or computer-based tests. Thanks to the wide-spreading of mobile devices, and the extensive capabilities that they have in dealing complex elements, it is possible to provide clinicians with tools for cognitive assessment. Contemporary 3D engine is, in general generally, able to deploy complex 3D environments for iOS, Android and Windows mobile, i.e., most of the mobile phone and tablet operative systems.Results: This brand-new scenario and pressing requests from professionals, pushed us to build an application for the assessment of USN. Our first attempt was to replicate the classic cognitive tests, traditionally used at this purpose. Ecological assessment is difficult in real scenarios so we implemented virtual environments to assess patients’ abilities in realistic situations. At the moment, the application is available only for iPad and iPhone for free, from the Apple Store, under the name of “Neglect App.” The App contains traditional tests (e.g., barrage with and without distractors) and ecological tests (e.g., to distribute the tea in a table to close people). Scoring of each test is available to the clinicians through a database with the executed ecological tasks, that are stored locally.Conclusion: In conclusion, Neglect App is an advanced mobile platform for the assessment of Neglect.

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Increase of frontal neuronal activity in chronic neglect after training in virtual reality

Cited by 31 publications

References 33 publications

Efficacy of virtual reality to reduce chronic low back pain: Proof-of-concept of a non-pharmacological approach on pain, quality of life, neuropsychological and functional outcome

Efficacy of virtual reality to reduce chronic low back pain: Proof-of-concept of a non-pharmacological approach on pain, quality of life, neuropsychological and functional outcome

<p>Unilateral Spatial Neglect After Stroke: Current Insights</p>

Assessment of Unilateral Spatial Neglect Using a Free Mobile Application for Italian Clinicians

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