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Published in Terence R. Anthoney, Neuroanatomy and the Neurologic Exam, 2017
Usually, both of the patient’s eyes are open, and the examiner’s fingers are used as the test objects. Most often, one object is presented in the left halves of the fields of both eyes and another object is presented in the analogous portion of the right halves of the fields of both eyes (e.g., DeJ, p. 99. A&V, p.189). This makes the presence of visual extinction analogous to other types of sensory extinction (e.g., DeJ, p. 63, for somatosensory; Bick, p. 238, for auditory). However, authors of one text describe use of the method with one of the patient’s eyes closed; and the two objects presented simultaneously may at times both be in the nasal half (or temporal half) of the field—one in the upper quadrant and the other in the lower quadrant (VanA&R, p. 26).
Successful return to professional work after neglect, extinction, and spatial misperception – Three long-term case studies
Published in Neuropsychological Rehabilitation, 2021
These three case studies show that RTW is possible despite left neglect, extinction, and spatial misperception after a right-hemisphere stroke. Interestingly, none of the three patients was able to return to his prior job after the first treatment phase, which included a combination of eye movement, scanning, and optokinetic (smooth pursuit eye movement) training. Though all three benefited from this training and their search times lay after the treatment in the normal range during visual search (see Figure 3) – without any indication of a left-sided residual neglect – all showed visual extinction for left-sided stimuli and severe spatial misperception after this first treatment block. As all three individuals had to deal with multiple, simultaneously occurring visual stimuli in their jobs (i.e., persons; cars; objects; paper- and computer work; reading and writing of documents; typing and reading emails; reading, writing, and using phone numbers), visual extinction caused severe problems in many situations of their daily life. I therefore invented the anti-extinction training to treat these problems.
Using real-time fMRI neurofeedback to restore right occipital cortex activity in patients with left visuo-spatial neglect: proof-of-principle and preliminary results
Published in Neuropsychological Rehabilitation, 2019
Fabien Robineau, Arnaud Saj, Rémi Neveu, Dimitri Van De Ville, Frank Scharnowski, Patrik Vuilleumier
To probe for any short-term effect on visual performance following neurofeedback training, we used two computerised visual tests that were given in the MR scanner: a perceptual line bisection test and a detection task (see details in Robineau et al., 2014). For line bisection (Landmark Test, Bisiach, Ricci, & Modona, 1998), participants used a keypad to indicate whether a marker along a horizontal black line was presented at the exact centre of the line (yes/no). We measured judgement error rates for the midpoint and the two first bisection mark positions on the left and right side around the midpoint, as well as the average response times. For the visual detection task, we calculated the correct detection rate for Gabor patches presented in each visual field (left, right, or both). Visual extinction was quantified separately for each visual field by computing the number of stimuli missed on bilateral trials minus unilateral trials, divided by the number of trials per condition (Pavlovskaya, Soroker, & Bonneh, 2007). Both tests were carried out before neurofeedback and after each training session. No functional BOLD measures were obtained during these tasks since they were too brief to obtain reliable fMRI data.
Frontal lesions predict response to prism adaptation treatment in spatial neglect: A randomised controlled study
Published in Neuropsychological Rehabilitation, 2020
Kelly M. Goedert, Peii Chen, Anne L. Foundas, A. M. Barrett
In contrast, the BIT may be more sensitive to perceptual-attentional deficits. Previously, we demonstrated an association between the BIT and visual extinction (Goedert et al., 2012). Others have demonstrated baseline BIT scores to be positively associated with tests of visual, but not proprioceptive, straight ahead (Rode et al., 2015). Thus, the BIT may be more likely to detect improvements in spatial neglect after prism adaptation employing a terminal exposure procedure, which is more likely to induce perceptual-attentional changes, than a concurrent exposure procedure, which is more likely to induce motor-intentional changes. Indeed, studies employing a terminal exposure prism adaptation procedure have observed significant improvements on the BIT (e.g., Frassinetti, Angeli, Meneghello, Avanzi, & Ladavas, 2002; Làdavas et al., 2011; Mizuno et al., 2011), while those employing a concurrent exposure procedure have not (e.g., Goedert et al., 2014; Nys, de Haan, Kunneman, de Kort, & Dijkerman, 2008; Rode et al., 2015). The BIT may also be less sensitive than the CBS to spatial-motor deficits associated with frontal lesions that are strongly linked to functional recovery. Nonetheless, other assessments that mimic real-life motor demands, such as virtual-reality-based navigation, may also be effective and sensitive at detecting neglect (Buxbaum, Dawson, & Linsley, 2012), as well as at detecting spatial-motor improvements associated with concurrent exposure prism adaptation procedures in neglect treatment (Glize et al., 2017). Future studies establishing the external validity of virtual reality and other similar assessment procedures, in large, representative patient groups with spatial neglect, are needed.