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Revista Colombiana de Psiquiatria May 2022Social distancing measures due to the COVID-19 pandemic prevented many children with neurodevelopmental disorders from accessing face-to-face treatments....
INTRODUCTION
Social distancing measures due to the COVID-19 pandemic prevented many children with neurodevelopmental disorders from accessing face-to-face treatments. Telerehabilitation grew at this time as an alternative therapeutic tool. In this study we analysed remote cognitive rehabilitation in neurodevelopmental disorders.
METHODS
This was a prospective, quasi-experimental (before-after) study that included 22 patients (mean age 9.41 years) with neurodevelopmental disorders who had telerehabilitation for over six months.
RESULTS
After six months of telerehabilitation, a statistically significant improvement was found with a large effect size in these areas: attention (sustained, selective and divided), executive functions (verbal and visual working memory, categorisation, processing speed), visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia) and language (comprehensive and expressive). On the Weiss Functional Impairment Scale, all areas (family, learning and school, self-concept, activities of daily living, risk activities) improved with statistical significance. We found a positive correlation between the number of sessions and the improvement observed in executive functions (visual working memory, processing speed), attention (sustained attention, divided attention) and visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia). We did not find statistical significance between the family structure and the number of sessions carried out. A high degree of perception of improvement and satisfaction was observed in the parents.
CONCLUSIONS
Telerehabilitation is a safe alternative tool which, although it does not replace face-to-face therapy, can achieve significant cognitive and functional improvements in children with neurodevelopmental disorders.
PubMed: 35600217
DOI: 10.1016/j.rcp.2022.03.003 -
Applied Neuropsychology. Adult 2022There is broad consensus on the utility of complex pictures in the assessment of simultanagnosia in patients with acquired brain injury (ABI). To overcome various...
There is broad consensus on the utility of complex pictures in the assessment of simultanagnosia in patients with acquired brain injury (ABI). To overcome various shortcomings of current instruments, we have developed the Birthday Party Test (BPT); a picture description test that contains a neutral scene, a balanced representation of events, and provides clear instructions and a scoring-aid. We have applied the BPT in a large group of patients with ABI ( = 502) and in an age-matched healthy control group ( = 194). Our results show that performance on the BPT was associated with a range of descriptive, neuropsychological and clinical characteristics and that poor test performance appeared to be more common in patients with etiologies that have an increased risk of bilateral damage. Furthermore, we assume a high correspondence between test performance on the BPT and the assessor's clinical judgment of likely having simultanagnosia in preliminary analyses. This study shows the potential usefulness of the BPT to support diagnostic decision making in simultanagnosia. The BPT is made freely available to facilitate its broad application in the clinical assessment of patients with visual impairment and to enable a further evaluation of its utility and validity in future studies.
Topics: Brain Injuries; Humans
PubMed: 32476466
DOI: 10.1080/23279095.2020.1763998 -
Neuropsychology Sep 2020Simultanagnosia, a deficit in holistic visual perception, is among the most prominent features of posterior cortical atrophy (PCA). Deficits in visuoperceptual and...
Simultanagnosia, a deficit in holistic visual perception, is among the most prominent features of posterior cortical atrophy (PCA). Deficits in visuoperceptual and attentional mechanisms could contribute to simultanagnosia. In the present study, we explored the impaired visual perception of global configuration with two main hypotheses: (a) It is due to a deficit in processing low-spatial frequency stimuli, and (b) it arises from deficits in adjusting attentional focus. The visuoperceptual mechanism was explored by asking participants (5 PCA patients and 20 age- and education-matched healthy controls) to report the local and global elements of incongruent hierarchical letters. Stimuli were unbiased (black letters/white background) and parvocellular biased (red letters/green background). A cued T-detection task, where the stimulus onset asynchrony and the cues' features varied, was used to explore focal attention. PCA patients systematically failed in reporting the global but not the local element. The parvocellular-biased condition partially improved the performance in only 1 patient. In the T-detection task, controls responded faster to targets cued by red dots and small cues as compared to no cues. Conversely, the cue's features did not affect patients' performance. Results only partially support the hypothesis according to which simultanagnosia is driven by an impairment in processing low-spatial frequencies. Data indicate a deficit in the flexibility of focal attention that prevents PCA patients from adapting the attentional window to the stimulus features. Simultanagnosia in PCA can be conceptualized as a complex result of a deficit involving visuoperceptual and exogenous attentional mechanisms. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
PubMed: 32940497
DOI: 10.1037/neu0000697 -
Indian Journal of Ophthalmology Jan 2020Simultanagnosia resulting from dorsal stream dysfunction is an under recognized condition. In this case report we describe the case of a young woman who developed...
Simultanagnosia resulting from dorsal stream dysfunction is an under recognized condition. In this case report we describe the case of a young woman who developed posterior reversible encephalopathy syndrome (PRES), and who recovered visual acuities of 20/20 in each eye, along with normal visual fields and contrast sensitivities, yet experienced persistent symptoms of perceptual dysfunction. Detailed and systematic history taking revealed consistent visual difficulties typical of dorsal stream dysfunction. After a detailed explanation of her symptomatology and training in a range of strategies to cope, the patient experienced a great improvement in her day-to-day functioning.
Topics: Adult; Agnosia; Brain; Female; Humans; Magnetic Resonance Imaging; Posterior Leukoencephalopathy Syndrome; Vision Disorders; Visual Acuity
PubMed: 31856545
DOI: 10.4103/ijo.IJO_807_19 -
Cerebral Cortex (New York, N.Y. : 1991) Jan 2021Simultanagnosia is an impairment in processing multiple visual elements simultaneously consecutive to bilateral posterior parietal damage, and neuroimaging data have...
Simultanagnosia is an impairment in processing multiple visual elements simultaneously consecutive to bilateral posterior parietal damage, and neuroimaging data have specifically implicated the superior parietal lobule (SPL) in multiple element processing. We previously reported that a patient with focal and bilateral lesions of the SPL performed slower than controls in visual search but only for stimuli consisting of separable lines. Here, we further explored this patient's visual processing of plain object (colored disk) versus object consisting of separable lines (letter), presented in isolation (single object) versus in triplets. Identification of objects was normal in isolation but dropped to chance level when surrounded by distracters, irrespective of eccentricity and spacing. We speculate that this poor performance reflects a deficit in processing objects' relative locations within the triplet (for colored disks), aggravated by a deficit in processing the relative location of each separable line (for letters). Confirming this, performance improved when the patient just had to detect the presence of a specific colored disk within the triplets (visual search instruction), while the inability to identify the middle letter was alleviated when the distracters were identical letters that could be grouped, thereby reducing the number of ways individual lines could be bound.
Topics: Adult; Agnosia; Attention; Cognition; Female; Humans; Neuroimaging; Parietal Lobe; Visual Perception
PubMed: 32959044
DOI: 10.1093/cercor/bhaa250 -
Neurology Oct 2022An 80-year-old woman who was experiencing visual symptoms for 2 years was found to have a left homonymous hemianopsia (HH). On further evaluation the following month,...
An 80-year-old woman who was experiencing visual symptoms for 2 years was found to have a left homonymous hemianopsia (HH). On further evaluation the following month, she was noted to have simultanagnosia and alexia. MRI of the brain did not reveal a structural etiology for the symptoms. [F]-fluorodeoxyglucose (FDG) PET-CT was performed to aid in the diagnostic investigation. This case of posterior cortical atrophy highlights the differential diagnosis of a HH in the absence of a structural lesion on MRI and the role of FDG PET-CT imaging in such patients.
Topics: Aged, 80 and over; Clinical Reasoning; Female; Fluorodeoxyglucose F18; Hemianopsia; Humans; Magnetic Resonance Imaging; Positron Emission Tomography Computed Tomography
PubMed: 36038269
DOI: 10.1212/WNL.0000000000201175 -
Clinical Nuclear Medicine Feb 2021Balint syndrome is a rare neurological disorder characterized by simultanagnosia, optic ataxia, and ocular apraxia, and its etiology can be very heterogeneous. Diagnosis...
Balint syndrome is a rare neurological disorder characterized by simultanagnosia, optic ataxia, and ocular apraxia, and its etiology can be very heterogeneous. Diagnosis is based on neuropsychological evaluation, but brain radiological and nuclear medicine imaging also plays an important role. Because few case reports have been published in literature, in this work, we present 2 patients affected by Balint syndrome in which 18F-FDG PET/CT helped in the diagnosis and follow-up.
Topics: Female; Fluorodeoxyglucose F18; Follow-Up Studies; Humans; Male; Middle Aged; Nervous System Diseases; Positron Emission Tomography Computed Tomography
PubMed: 33065619
DOI: 10.1097/RLU.0000000000003335 -
Rinsho Shinkeigaku = Clinical Neurology Oct 2023A 76-year-old male patient was admitted to our hospital for the treatment of acute cerebral infarction in the right temporal stem, right lateral thalamus, and right...
A 76-year-old male patient was admitted to our hospital for the treatment of acute cerebral infarction in the right temporal stem, right lateral thalamus, and right pulvinar regions. Although his overall cognitive function was almost normal, he exhibited reduced visual sensitivity in the homonymous lower left quadrant of the visual field, left unilateral spatial neglect (USN), and simultanagnosia. Left USN improved 4 months after the onset of infarction; however, simultanagnosia persisted. To the best of our knowledge, this is the first case of simultanagnosia caused by cerebral infarction in the right temporal stem, right lateral thalamus, and right pulvinar regions.
Topics: Male; Humans; Aged; Pulvinar; Thalamus; Cerebral Infarction; Agnosia; Perceptual Disorders
PubMed: 37779025
DOI: 10.5692/clinicalneurol.cn-001846 -
Perceptual and Motor Skills Feb 2024Typical visual perception includes an attention bias toward right hemisphere mediated global, holistic cortical processing. An atypically local, detail-oriented focus of...
Typical visual perception includes an attention bias toward right hemisphere mediated global, holistic cortical processing. An atypically local, detail-oriented focus of attention is characteristic of left hemisphere processing and is often observed in patients whose field of attention is restricted by certain types of neurocognitive impairment. We designed the present pair of studies to induce a local attentional focus to observe its consequences on neurocognitive measures of visuospatial processing. In Experiment I, participants wore glasses mimicking simultanagnosia, a disorder of visual attention, to induce a narrowed, atypical attentional style while they completed visual neuropsychological tasks. This simulation impaired participants' capacities to visually synthesize and efficiently reproduce Complex Figure stimuli as measured with the Boston Qualitative Scoring System (BQSS), and it induced an atypical attentional style on Rorschach Performance Assessment System (R-PAS) responses. In Experiment II, participants wore glasses designed to provoke differential hemispheric activation, also hypothesized to influence style of visual attention; but this manipulation did not influence neurocognitive task performance. We discuss implications for the interpretation of BQSS and R-PAS scores and offer directions for future research.
Topics: Humans; Visual Perception; Bias; Attention; Functional Laterality
PubMed: 38253419
DOI: 10.1177/00315125241228128 -
Der Nervenarzt Aug 2023Neglect occurring after stroke, neoplasms or degenerative processes can lead to considerable disability in everyday life as can other disorders of spatial orientation....
Neglect occurring after stroke, neoplasms or degenerative processes can lead to considerable disability in everyday life as can other disorders of spatial orientation. Therefore, a dedicated examination and early diagnostic classification are obligatory. Behavioral tests are helpful in this respect, enabling the clinician to obtain an initial overview of the existing deficits even at the patient's bedside. The clinical (bedside) examination of spatial neglect as well as the corresponding differential diagnostic procedure for the clarification of (possibly additionally or exclusively existing) hemianopia and extinction, as well as the examination of disorders of visuospatial perception, visuoconstructive disorders, topographic disorders, Bálint's syndrome, simultanagnosia, and optic ataxia are presented. The presentation is based on the newly revised (year 2023) guidelines of the Association of the Scientific Medical Societies in Germany (AWMF) on this subject area.
Topics: Humans; Visual Perception; Cognition; Perceptual Disorders; Stroke; Apraxias
PubMed: 37535111
DOI: 10.1007/s00115-023-01525-0