Visual Neglect in Parkinson's Disease

Villardita, Claudio; Smirni, Pietro; Zappalà, Giuseppe

doi:10.1001/archneur.1983.04050110055008

Cited by 80 publications

(43 citation statements)

References 19 publications

(1 reference statement)

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“…The imbalance in cortico-subcortical circuits caused by DBS of the left STN only is similar to left hemiparkinsonism with a relative right-sided striatal hypodopaminergic state. In predominantly left-sided PD, previous studies have demonstrated a tendency to cross lines to the right of the middle, 42 a right-sided orientation in a line-crossing-out test, 43 and the directional bias of initial visual exploration. 44 The neglect found after left-side stimulation exclusively is similar to signs and symptoms of neglect in predominantly left-sided PD patients reported by Lee and colleagues.…”

Section: Discussionmentioning

confidence: 93%

Change in artistic expression related to subthalamic stimulation

Witt¹,

Krack²,

Deuschl³

2006

J Neurol

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While the role of frontal and parietal cortex in spatial orientation has been studied extensively, the contribution of the basal ganglia and especially the subthalamic nucleus to spatial orientation remains less clear. Here we use subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson's disease (PD) as a reversible model of functional lesioning to evaluate the influence of the STN in extrapersonal space orientation. To this end, 12 PD patients were examined 1 year after implantation of DBS electrodes in the STN after overnight withdrawal of L-dopa. Patients were tested in a pseudorandomized order while both stimulators, the right only, the left only, or no stimulator, were switched on. Patients performed line bisection and a reaction time task responding to stimuli of the middle, the left, and the right extrapersonal space. A separate assessment of the right and left hand responding to visual stimuli in each hemispace made it possible to distinguish hemispatial and hemimotor impairments. No asymmetries in space orientation were found when both stimulators were switched OFF, when both stimulators were switched ON, and when only the right stimulator was switched ON. When only the left subthalamic stimulation was switched ON, the reaction times of both hands to visual stimuli in the left extrapersonal hemispace increased significantly and the line bisection test showed a significant orientation to the right. These results lead to the conclusion that the STN and its cortical projections influence the network involved in visuospatial orientation. These patterns of symptoms of neglect demonstrate the influence of the STN on the attentional system of the nondominant hemisphere.

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Section: Discussionmentioning

confidence: 93%

Change in artistic expression related to subthalamic stimulation

Witt¹,

Krack²,

Deuschl³

2006

J Neurol

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“…Why such an association is specific to left-handed finger tapping speed remains to be determined, but it could be due to greater right-hemisphere involvement in attentional processes (Corbetta, et al, 2002). In addition, a few previous studies have indicated that left-sided symptoms in PD patients were associated with attentional impairment (Starkstein, et al, 1987;Villardita, et al, 1983), suggesting that dysfunction within the right hemisphere may be specific to the attentional impairment in PD. Further research will have to be conducted in order to more precisely determine the relationship between the type of attentional deficits observed in the present study and the specific motor impairments exhibited in patients with PD.…”

Section: Discussionmentioning

confidence: 99%

Flanker compatibility effects in patients with Parkinson’s disease: Impact of target onset delay and trial-by-trial stimulus variation

Cagigas¹,

Filoteo

Stricker

et al. 2007

Brain and Cognition

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Parkinson's disease (PD) patients and healthy controls were administered a flanker task that consisted of the presentation of colored targets and distractors. Participants were required to attend to the center target and identify its color. The stimulus displays were either congruent (i.e., the target and flankers were the same color) or incongruent. The time between the onset of the flanker and the target color (the target onset delay) was either short or long. Results indicated that PD patients and controls did not differ in the magnitude of the flanker effect within individual trials in that both groups demonstrated a typical flanker effect at the short target onset delay and neither group demonstrated a flanker effect at the longer delay. However, when performance was examined on a trial-by-trial basis, PD patients demonstrated a slowing of reaction time relative to controls when having to make the same response across consecutive trials at longer inter-trial intervals when the flankers were incongruent across consecutive trials and the display on the second of two trials was incongruent. These results indicate that PD patients are impaired in inhibiting the distractors over an extended delay and that this deficit may impact motor responding in these patients, suggesting that the basal ganglia contribute to the interface of attention and action.

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“…Also, among patients affected by stroke, cognitive impairment seems to be more frequently associated with infarctions in the arterial territories of the left hemisphere (Tatemichi et al, 1994). Although it has been suggested that right and left PD may have differing effects on behaviour (Barber et al, 1985;Fleminger, 1991) and cognition (Bentin et al, 1981;Direnfeld et al, 1984), the influence of motor asymmetry on the pattern of neuropsychological performances still largely remains uncertain (Direnfeld et al, 1984;Bowen et al, 1972;Bentin et al, 1981;Villardita et al, 1983;Boller et al, 1984;Chouza et al, 1984;Yochochi et al, 1985;Taylor et al, 1986;Oyebode et al, 1986;Starkstein et al, 1987;Spicer et al, 1988;Huber et al, 1989aHuber et al, , 1992Blonder et al, 1989;Reid et al, 1989;Agniel et al, 1991;Mohr et al, 1992;Tomer et al, 1993;Viitanen et al, 1994). Furthermore, there is very little information about the predictive value of initial extrapyramidal lateralization as it relates to the appearance of dementia (Direnfeld et al, 1984).…”

Section: Introductionmentioning

confidence: 99%

Neuropsychological characteristics of parkinsonian patients with lateralized motor impairment

Finali

Piccirilli

Rizzuto

1995

J Neural Transm Gen Sect

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Parkinsonians with predominantly unilateral signs provide an interesting experimental means to evaluate if asymmetric nigro-striatal degeneration may affect neuropsychological functions. The aim of our study was to establish if the side of onset of idiopathic Parkinson's disease, right (PDR) or left (PDL), determines a selective pattern of cognitive performances. Furthermore, we verified if PDR and PDL groups show a different frequency of dementia. PDR and PDL patients with at least seven years of disease duration, matched for age, schooling, severity of extrapyramidal symptomatology and index of lateralization, were evaluated by using an extensive neuropsychological battery aimed at assessing hemispheric cognitive asymmetries. Current side of greater motor impairment was the same as the one affected at the onset of the disease. Only subtle differences in the profile of neuropsychological dysfunction emerged from the comparison of PDR and PDL subjects. Moreover, the number of parkinsonians showing dementia syndrome was the same in both groups. Our results suggest that the side of onset of motor impairment does not significantly influence the cognitive performances in PD. Subcortical anatomic and/or functional asymmetries seem to play a less important role in the intellectual functions than in motor activities.

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Visual Neglect in Parkinson's Disease

Cited by 80 publications

References 19 publications

Change in artistic expression related to subthalamic stimulation

Change in artistic expression related to subthalamic stimulation

Flanker compatibility effects in patients with Parkinson’s disease: Impact of target onset delay and trial-by-trial stimulus variation

Neuropsychological characteristics of parkinsonian patients with lateralized motor impairment

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