ObjectiveSpatial Neglect is prevalent among stroke survivors, yet few treatments have evidence supporting efficacy. This study examines the feasibility of Prism Adaptation Treatment (PAT) within an inpatient rehabilitation facility and... more
ObjectiveSpatial Neglect is prevalent among stroke survivors, yet few treatments have evidence supporting efficacy. This study examines the feasibility of Prism Adaptation Treatment (PAT) within an inpatient rehabilitation facility and the degree by which PAT improves symptoms of spatial neglect and functional independence among sub-acute survivors of right hemispheric stroke.DesignIn this retrospective cohort study, 37 right hemispheric stroke patients were identified as having received at least 4 PAT sessions during their inpatient stay. Spatial neglect and functional independence levels of patients in the PAT cohort were compared to a matched active control group comprised of rehabilitation patients receiving alternative therapies to address neglect admitted during the same time period.ResultsMost patients received the full recommended 10 sessions of PAT (average sessions completed = 8.6). A higher percentage of severe neglect patients receiving PAT (69%) displayed clinically sig...
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OBJECTIVE This study examined lexical and neuroanatomic correlates of reading errors in individuals with spatial neglect, defined as a failure to respond to stimuli in the side of space opposite a brain lesion, causing functional... more
OBJECTIVE This study examined lexical and neuroanatomic correlates of reading errors in individuals with spatial neglect, defined as a failure to respond to stimuli in the side of space opposite a brain lesion, causing functional disability. METHOD One-hundred and ten participants with left spatial neglect after right-hemisphere stroke read aloud a list of 36 words. Reading errors were scored as "contralesional" (error in the left half of the word) or as "other." The influence of lexical processing on neglect dyslexia was studied with a stepwise regression using word frequency, orthographic neighborhood (number of same length neighbors that differ by 1 letter), bigram and trigram counts (number of words with the same 2- and 3-letter combinations), length, concreteness, and imageability as predictors. MRI/CT images of 92 patients were studied in a voxelwise lesion-symptom analysis (VLSM). RESULTS Longer length and more trigram neighbors increased, while higher concreteness reduced, the rate of contralesional errors. VLSM revealed lesions in the inferior temporal sulcus, middle temporal and angular gyri, precuneus, temporal pole, and temporo-parietal white matter associated with the rate of contralesional errors. CONCLUSIONS Orthographic competitors may decrease word salience, while semantic concreteness may help constrain the selection of available word options when it is based on degraded information from the left side of the word. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Research Interests: Psychology, Cognitive Psychology, Phonology, Semantics, Cognition, and 6 moreAphasia, MRI, Reading, Medicine, Orthography, and Stroke
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Spatial neglect (SN) constitutes a substantial barrier to functional recovery after acquired brain injury. However, because of its multimodal nature, no single test can capture all the signs of SN. To provide a clinically feasible... more
Spatial neglect (SN) constitutes a substantial barrier to functional recovery after acquired brain injury. However, because of its multimodal nature, no single test can capture all the signs of SN. To provide a clinically feasible solution, we used conventional neuropsychological tests as well as the Catherine Bergego Scale (CBS) via the Kessler Foundation Neglect Assessment Process (KF-NAP). The goal was to add evidence that a global approach should detect better even subtle signs of SN. Fourteen individuals with lesions located in the right cerebral hemisphere participated in the study. Participants were assessed with a comprehensive battery of neuropsychological tests, comprising a set of visuospatial tests to evaluate several spatial domains. In addition, patients underwent functional assessment with the Barthel Index, the Functional Independence Measure (FIM), and the CBS via KF-NAP. The CBS via KF-NAP was associated with the visuospatial paper-based tests (p = .004) as well as...
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Research Interests: Psychology, Cognitive Science, Perception, Psychophysiology, Mental Representation, and 15 moreCognition, Attention, Categorization, Spatial Representation, Humans, Discrimination Learning, Form perception, Orientation, Concept Formation, Object Recognition, Reaction Time, Distance Perception, Human Vision, Adult, and Hemispheric Specialization
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A critical memory skill rarely clinically tested is the ability to remember self-generated material. Healthy aged participants (n = 30; Experiment 1) and pilot participants with probable Alzheimer disease (pAD) (n = 9; Experiment 2) were... more
A critical memory skill rarely clinically tested is the ability to remember self-generated material. Healthy aged participants (n = 30; Experiment 1) and pilot participants with probable Alzheimer disease (pAD) (n = 9; Experiment 2) were twice administered a memory test including both internally generated and externally supplied items for recall. Healthy aged participants were biased to recall internally originating over externally supplied material on first, but not second, presentation. However, pAD participants demonstrated internal bias during both sessions. The pAD participants were also specifically impaired when told to remember internal material. This study provides further evidence that internally originating items can be used to assess memory. In pAD, memory for internal material with specific attempt to remember may be selectively impaired.
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Eye patching biases spatial attention after thalamic hemorrhage in a patient without spatial neglect: a case report 1 1 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organiz...more
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Research Interests: Cognitive Science, Perception, Adolescent, Humans, Discrimination Learning, and 14 moreOrientation, Female, Male, Cortex, Distance Perception, Line Bisection, Optical Illusions, Motor System, Adult, Sensory Deprivation, Neurosciences, Attentional Bias, Psychomotor Performance, and Neuropsychological Tests
Research Interests: Personality, Individuality, Magnetic Resonance Imaging, Morphometry, Adolescent, and 15 moreBrain Mapping, Brain, Humans, Child, Correlation, Human behavior, Female, Male, Brain Volume, Individual Difference, Nuclear Magnetic Resonance Imaging, Cross Sectional Studies, Anterior cingulate cortex, Magnetic resonance image, and Medical and Health Sciences
Patients who have the classic combination of progressive memory loss and problems retrieving stored knowledge that is characteristic of Alzheimer's disease may actually have another,... more
Patients who have the classic combination of progressive memory loss and problems retrieving stored knowledge that is characteristic of Alzheimer's disease may actually have another, treatable disorder. In these cases, appropriate evaluation can reveal the true diagnosis and guide therapy to stabilize or improve thinking and avert other complications. In this article, Dr Barrett explores 10 conditions that may be mistaken for Alzheimer's disease.
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Research Interests: Semantic Network and PNAS
Page 1. SYMPOSIAINTRODUCTION The changing view of neurorehabilitation: A new era of optimism LESLIE J. GONZALEZ ROTHI1,2 and ANNA M. BARRETT3, 4 1Brain Rehabilitation Research Center and Geriatric Research ...
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Several studies have demonstrated that patients with right hemisphere damage, when compared with left-hemisphere damaged controls, are impaired at comprehending emotional prosody. Critics of these studies, however, note that selection may... more
Several studies have demonstrated that patients with right hemisphere damage, when compared with left-hemisphere damaged controls, are impaired at comprehending emotional prosody. Critics of these studies, however, note that selection may have been biased because left-hemisphere-damaged subjects had good verbal comprehension. To learn whether a subject with a large left hemisphere stroke and global aphasia could comprehend emotional prosody in spoken material. The authors formally tested speech and language with the Western Aphasia Battery and comprehension of emotional prosody and emotional facial expression with the Florida Affect Battery. The patient could not perform verbally mediated tests but demonstrated spared ability to match emotional prosody to emotional facial expressions under a variety of conditions. These observations further support the idea that verbal and emotional communication systems are independent and mediated by different hemispheres.
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Objective: To demonstrate that externally modifying superior colliculus activity may lead to observable changes in spatial bias. Background: Sprague 1966 first described an experiment where ablation of the contralesional superior... more
Objective: To demonstrate that externally modifying superior colliculus activity may lead to observable changes in spatial bias. Background: Sprague 1966 first described an experiment where ablation of the contralesional superior colliculus (SC) led to improvements on spatial tasks in cats with induced parietal neglect. Since then, studies have shown that: (1) isolated deactivation of the SC may result in asymmetric spatial behavior, and (2) right visuoparietal damage may reduce input and activity in the ipsilesional SC. We hypothesized that stimulating the right SC may alter spatial performance bias. We also compared this effect with prism adaptation. Methods: A.A. is a 29yearold woman who presented with spatial bias and extinction following a right midbrain/collicular hemorrhage. On Visit 1, A.A. underwent a computerized linebisection task with and without SC stimulation with dual rotating checkerboards and right hemipatching. For comparison, on Visit 2, A.A. underwent the task be...
OBJECTIVE: To determine whether perseveration marks more severe spatial neglect (SN) and functional disability. If different neural mechanisms underlie functional disability due to SN versus perseveration, functional disability may not... more
OBJECTIVE: To determine whether perseveration marks more severe spatial neglect (SN) and functional disability. If different neural mechanisms underlie functional disability due to SN versus perseveration, functional disability may not increase when both deficits are present. BACKGROUND: SN is characterized by the inability to attend, respond, or act toward contralesional stimuli. SN often co-occurs with perseveration, characterized by repetitive movement in one location. Symptoms of both SN and perseveration can be observed during the same task, such as target cancellation, but may be related to different neural mechanisms. DESIGN/METHODS: Retrospective analysis of right brain stroke survivors screened for SN (n=136; 52.9[percnt] female; age: M=65.9 yrs, SD=14.76). Participants completed the Behavioral Inattention Test (BIT), Mini-Mental Status Exam (MMSE), Luria Contrasting Programs (CP), and Barthel Index (BI). BIT scores below 129 were classified as SN. Repeated cancellations in...
Many stroke survivors are not aware of the behavioral and cognitive deficits that may develop in the days and weeks following stroke. For example, nearly half of all survivors of right hemisphere stroke develop spatial neglect, a... more
Many stroke survivors are not aware of the behavioral and cognitive deficits that may develop in the days and weeks following stroke. For example, nearly half of all survivors of right hemisphere stroke develop spatial neglect, a visuospatial dysfunction featuring a failure to report, respond, or orient towards contralesional stimuli. Stroke survivors with spatial neglect often produce repetitive and redundant motor actions during goal-directed tasks. For example, in a cancellation task stroke survivors will cancel the target by producing more than one mark (repeated markings; RM) or they may use a continuous uninterrupted movement producing a “scribble”. While both responses are considered perseverations, it is unclear whether they are a symptom of spatial neglect or a co-occurring distinct disorder. To better understand if similar or distinct neural mechanisms underlie perseveration and spatial neglect we assessed lesion profiles, cognitive functioning, and spatial neglect severit...
To evaluate the evidence basis of single-domain cognitive tests frequently used by behavioral neurologists in an effort to improve the quality of clinical cognitive assessment. Behavioral Neurology Section members of the American Academy... more
To evaluate the evidence basis of single-domain cognitive tests frequently used by behavioral neurologists in an effort to improve the quality of clinical cognitive assessment. Behavioral Neurology Section members of the American Academy of Neurology were surveyed about how they conduct clinical cognitive testing, with a particular focus on the Neurobehavioral Status Exam (NBSE). In contrast to general screening cognitive tests, an NBSE consists of tests of individual cognitive domains (e.g., memory or language) that provide a more comprehensive diagnostic assessment. Workgroups for each of 5 cognitive domains (attention, executive function, memory, language, and spatial cognition) conducted evidence-based reviews of frequently used tests. Reviews focused on suitability for office-based clinical practice, including test administration time, accessibility of normative data, disease populations studied, and availability in the public domain. Demographic and clinical practice data were...