PubMed Health⌕ Search

Biomedical subjects

E Làdavas

Publications and source records attributed to E Làdavas.

At least 19 recordsLinked to original sources
PubMed2004

Patterns of spontaneous recovery of neglect and associated disorders in acute right brain-damaged patients.

OBJECTIVES: The evolutionary pattern of spontaneous recovery from acute neglect was studied by assessing cognitive deficits and motor impairments. Detailed lesion reconstruction was also performed to correlate the presence of and recovery from neglect to neural substrates. METHODS: A consecutive series of right brain-damaged (RBD) patients with and without neglect underwent weekly tests in the acute phase of the illness. The battery assessed neglect deficits, neglect-related deficits, and motor impairment. Age-matched normal subjects were also investigated to ascertain the presence of non lateralised attentional deficits. Some neglect patients were also available for later investigation during the chronic phase of their illness. RESULTS: Partial recovery of neglect deficits was observed at the end of the acute period and during the chronic phase. Spatial attention was impaired in acute neglect patients, while non spatial attentional deficits were present in RBD patients with and without acute neglect. A strong association was found between acute neglect and fronto-parietal lesions. Similar lesions were associated with neglect persistence. In the chronic stage, neglect recovery was paralleled by improved motor control of the contralesional upper limb, thus emphasising that neglect is a negative prognostic factor in motor functional recovery. CONCLUSIONS: These findings show that spatial attention deficits partially improve during the acute phase of the disease in less than half the patients investigated. There was an improvement in left visuospatial neglect at a later, chronic stage of the disease, but this recovery was not complete.

Acute Disease↗
PubMed2001

Passive limb movements improve visual neglect.

Recent studies have reported that left neglect can be ameliorated during active movements of a contralesional limb in the contralesional space. In contrast, a passive left hand movement does not seem to induce an amelioration of neglect, at least when it is associated to simultaneous active right movement (Robertson IH, North N, Neuropsychologia 31 (1993) 293-300). In the present study, we explored the possibility that a complex passive movement, such as abduction and adduction of the arm, is able to reduce neglect also when it is associated to simultaneous active right arm movements. To test this hypothesis neglect patients were required to perform an object cancellation test and a line bisection test by using the right hand, while the left arm was passively moved. Moreover, we verified the possibility that left arm stimulation activates the peripersonal more than the extrapersonal space, with the exception of the condition in which the far space can be reached by a tool that extends peripersonal space in the far space (Farnè A, Làdavas E, Neuroreport 11 (2000) 1645-1649). For this reason, patients were required to perform the tasks in near (70 cm) and in far (140 cm) space by means of a light pen (pointing task) and of a stick (reaching task). When the left arm was passively moved the results showed a significant reduction of neglect with respect to the baseline condition, and the improvement equally affected the near and the far space. A different effect for the near and far space was observed in relation to the task (pointing vs. reaching). In the pointing task, neglect was more severe in the far than in near space; however, this difference disappeared when the patients had to reach objects by means of a stick. In conclusion, the present study shows that the entity of improvement of visual neglect due to a left passive movement is related to the entity of proprioceptive signals specifying left hand position.

Aged↗
PubMed2001

Deficit of auditory space perception in patients with visuospatial neglect.

There have been many studies of visuospatial neglect, but fewer studies of neglect in relation with other sensory modalities. In the present study we investigate the performance of six right brain damaged (RBD) patients with left visual neglect and six RBD patients without neglect in an auditory spatial task. Previous work on sound localisation in neglect patients adopted measure of sound localisation based on directional motor responses (e.g., pointing to sounds) or judgement of sound position with respect to the body midline (auditory midline task). However, these measures might be influenced by non-auditory biases related with motor and egocentric components. Here we adopted a perceptual measure of sound localisation, consisting in a verbal judgement of the relative position (same or different) of two sequentially presented sounds. This task was performed in a visual and in a blindfolded condition. The results revealed that sound localisation performance of visuospatial neglect patients was severely impaired with respect to that of RBD controls, especially when sounds originated in contralesional hemispace. In such condition, neglect patients were always unable to discriminate the relative position of the two sounds. No difference in performance emerged as a function of the visual condition in either group. These results demonstrate a perceptual deficit of sound localisation in patients with visuospatial neglect, suggesting that the spatial deficits of these patients can arise multimodally for the same portion of external space.

Adult↗
PubMed2001

Auditory peripersonal space in humans: a case of auditory-tactile extinction.

Animal experiments have shown that the spatial correspondence between auditory and tactile receptive fields of ventral pre-motor neurons provides a map of auditory peripersonal space around the head. This allows neurons to localize a near sound with respect to the head. In the present study, we demonstrated the existence of an auditory peripersonal space around the head in humans. In a right-brain damaged patient with tactile extinction, a sound delivered near the ipsilesional side of the head extinguished a tactile stimulus delivered to the contralesional side of the head (cross-modal auditory-tactile extinction). In contrast, when an auditory stimulus was presented far from the head, cross-modal extinction was dramatically reduced. This spatially specific cross-modal extinction was found only when a complex sound like a white noise burst was presented; pure tones did not produce spatially specific cross-modal extinction. These results show a high degree of functional similarity between the characteristics of the auditory peripersonal space representation in humans and monkeys. This similarity suggests that analogous physiological substrates might be responsible for coding this multisensory integrated representation of peripersonal space in human and non-human primates.

Aged↗
PubMed2000

Dynamic size-change of hand peripersonal space following tool use.

Humans and monkeys share similar sensory integrated processing of tactile and peri-hand visual inputs for coding peripersonal space surrounding the hand. In monkeys, tool use is known to induce a transient elongation of hand-centred peripersonal space along the tool axis. Here we report evidence that, also in humans, the use of a tool can increase the spatial extent of the representation of peri-hand visual space to incorporate the tool. We investigated this phenomenon in patients with tactile extinction, by using a cross-modal paradigm well suited to reveal visual-tactile integration near patients' hand. In the present study cross-modal extinction was assessed far from patients' ipsilesional hand, at the distal edge of a hand-held rake. We found that cross-modal extinction was more severe after patients used the rake to retrieve distant objects with respect to a condition in which the rake was not used. This evidence of an expansion of peri-hand space lasted only a few minutes after tool use. By contrast, peri-hand space expansion was not observed when motor actions towards distant objects did not involve the tool. These findings show that visual peri-hand space has important dynamic properties in humans; it can be expanded and contracted depending upon tool use.

Aged↗
PubMed2000

Seeing or not seeing where your hands are.

Previous findings have demonstrated the existence of a visual peripersonal space centered on the hand in humans and its modulatory effects on tactile perception. A strong modulatory effect of vision on touch perception was found when a visual stimulus was presented near the hand. In contrast, when the visual stimulus was presented far from the hand, only a weak modulatory effect was found. The aim of the present study was to verify whether such cross-modal links between touch and vision in the peripersonal space centered on the hand could be mediated by proprioceptive signals specifying the current hand positions or if they directly reflect an interaction between two sensory modalities, i.e., vision and touch. To this aim, cross-modal effects were studied in two different experiments: one in which patients could see their hands and one in which vision of their hands was prevented. The results showed strong modulatory effects of vision on touch perception when the visual stimulus was presented near the seen hand and only mild effects when the vision of the hand was prevented. These findings are explained by referring to the activity of bimodal neurons in premotor and parietal cortex of macaque, which have tactile receptive fields on the hand, and corresponding visual receptive fields in the space immediately adjacent to the tactile fields. One important feature of these bimodal neurons is that their responsiveness to visual stimuli delivered near the body part is reduced or even extinguished when the view of the body part is prevented. This implies that, at least for the hand, the vision of the hand is crucial for determining the spatial mapping between vision and touch that takes place in the peripersonal space. In contrast, the proprioceptive signals specifying the current hand position in space do not seem to be relevant in determining the cross-modal interaction between vision and touch.

Aged↗
PubMed2000

Left tactile extinction following visual stimulation of a rubber hand.

In close analogy with neurophysiological findings in monkeys, neuropsychological studies have shown that the human brain constructs visual maps of space surrounding different body parts. In right-brain-damaged patients with tactile extinction, the existence of a visual peripersonal space centred on the hand has been demonstrated by showing that cross-modal visual-tactile extinction is segregated mainly in the space near the hand. That is, tactile stimuli on the contralesional hand are extinguished more consistently by visual stimuli presented near the ipsilesional hand than those presented far from it. Here, we report the first evidence in humans that this hand-centred visual peripersonal space can be coded in relation to a seen rubber replica of the hand, as if it were a real hand. In patients with left tactile extinction, a visual stimulus presented near a seen right rubber hand induced strong cross-modal visual-tactile extinction, similar to that obtained by presenting the same visual stimulus near the patient's right hand. Critically, this specific cross-modal effect was evident when subjects saw the rubber hand as having a plausible posture relative to their own body (i.e. when it was aligned with the subject's right shoulder). In contrast, cross-modal extinction was strongly reduced when the seen rubber hand was arranged in an implausible posture (i. e. misaligned with respect to the subject's right shoulder). We suggest that this phenomenon is due to the dominance of vision over proprioception: the system coding peripersonal space can be 'deceived' by the vision of a fake hand, provided that its appearance looks plausible with respect to the subject's body.

Aged↗
PubMed1998

Neuropsychological evidence of the functional integration of visual, auditory and proprioceptive spatial maps.

We infer the functional integration of the visual, auditory and proprioceptive spatial maps from the behaviour of a patient (G.A.) with left visual neglect, i.e. a derangement of visual space representation. G.A. was required to point manually to left, centre or right acoustic stimuli, under visual control or blindfolded, with the responding hand (left or right) located either on the left, centre or right space. G.A.'s manual pointing responses to left auditory stimuli were strongly influenced by the visual spatial information and by the proprioceptive spatial information related to the position of the responding effector. In the visual control condition, when the patient performed the task with the left effector located on the left, pointing responses to left auditory stimuli were shifted towards the right intact visual space. In contrast, when the visual spatial information was rendered less salient, i.e. in the blindfolded condition, and the effector was again located on the left, manual pointing responses were confined to the previously ignored left space. These findings are consistent with the view that the acoustic representation is modulated by the impaired visual representation and by the proprioceptive spatial map related to the position of the responding effector.

Acoustic Stimulation↗
PubMed1998

In search of biased egocentric reference frames in neglect.

The present study was aimed at assessing, by means of visual as well as proprioceptive-kinaesthetic straight-ahead tasks, the possible causal role of the ipsilesional deviation of the egocentric reference frame in determining neglect syndrome. The hypothesis, originally proposed by Ventre et al. [3], that an alteration of the representation of body-centred space can be a cause of asymmetrical spatial behaviour in humans has been recently revived by Karnath and co-workers [24]. The results of the present study seem to challenge the view that a systematic ipsilesional displacement of the egocentric reference is the crucial mechanism responsible for unilateral visual neglect. Under visual conditions, in which patients were required to stop a moving spot as it crossed their perceived midline, the ipsilesional deviation of the egocentric reference frame was dependent upon the direction of visual scanning. Right to left visual scanning direction produced a rightward displacement of the egocentric reference. In contrast, left to right visual scanning direction allowed neglect patients to correctly locate their perceived egocentre with an accuracy which did not differ from controls. The notion that the effect of a deviation of the egocentric reference frame is actually dependent on a bias in the visual scanning orienting response was also confirmed in the proprioceptive straight-ahead pointing tasks, in which the patients were blindfolded and therefore no visual information was available. In these conditions, in which patients were required to judge the subjective midline by using head, trunk and shoulder co-ordinate systems, the displacement of the subjective egocentric midline was not present.

Adult↗
PubMed1998

Visual peripersonal space centred on the face in humans.

A convergent series of studies in monkeys and man suggests that the computation of visual space is performed in several brain regions for different behavioural purposes. Among these multiple spatial areas, the ventral intraparietal cortex, the putamen and the ventral aspect of the premotor cortex (area 6) contain a system for representing visual space near the face (peripersonal space). In these cerebral areas some neurons are bimodal: they have tactile receptive fields on the face, and they can also be driven by visual stimuli located near the tactile field. The spatial correspondence between the visual and tactile receptive fields provides a map of near visual space coded in body-part-centred co-ordinates. In the present study we demonstrate for the first time the existence of a visual peripersonal space centred on the face in humans. In patients with right hemispheric lesions, visual stimuli delivered in the space near the ipsilesional side of the face extinguished tactile stimuli on the contralesional side (cross-modal visuotactile extinction) to the same extent as did an ipsilesional tactile stimulation (unimodal tactile extinction). Furthermore, a visual stimulus presented in the proximity of the contralesional side of the face improved the detection of a left tactile stimulus: i.e. under bilateral tactile presentation patients were more accurate to report the presence of a left tactile stimulus when a simultaneous visual stimulus was presented near the left side of the face. However, when visual stimuli were delivered far from the face, visuotactile extinction and visuotactile facilitation effects were dramatically reduced. These findings are consistent with the hypothesis of a representation of visual peripersonal space coded in bodypart-centred co-ordinates, and they provide a striking demonstration of the modularity of human visual space.

Adult↗
PubMed1998

Neuropsychological evidence of an integrated visuotactile representation of peripersonal space in humans.

Current interpretations of extinction suggest that the disorder is due to an unbalanced competition between ipsilesional and contralesional representations of space. The question addressed in this study is whether the competition between left and right representations of space in one sensory modality (i.e., touch) can be reduced or exacerbated by the activation of an intact spatial representation in a different modality that is functionally linked to the damaged representation (i.e., vision). This hypothesis was tested in 10 right-hemisphere lesioned patients who suffered from reliable tactile extinction. We found that a visual stimulus presented near the patient"s ipsilesional hand (i.e., visual peripersonal space) inhibited the processing of a tactile stimulus delivered on the contralesional hand (cross-modal visuotactile extinction) to the same extent as did an ipsilesional tactile stimulation (unimodal tactile extinction). It was also found that a visual stimulus presented near the contralesional hand improved the detection of a tactile stimulus applied to the same hand. In striking contrast, less modulatory effects of vision on touch perception were observed when a visual stimulus was presented far from the space immediately around the patient"s hand (i.e., extrapersonal space). This study clearly demonstrates the existence of a visual peripersonal space centered on the hand in humans and its modulatory effects on tactile perception. These findings are explained by referring to the activity of bimodal neurons in premotor and parietal cortex of macaque, which have tactile receptive fields on the hand and corresponding visual receptive fields in the space immediately adjacent to the tactile fields.

Aged↗
PubMed1997

Neglect as a deficit determined by an imbalance between multiple spatial representations.

A previous study on neglect suggested that at least two hand parameters are crucial in producing an amelioration of neglect: the hand (left or right) and the spatial position of the hand (left or right). The improvement observed in perceiving left targets when the left hand acts in the left space can be due either to proprioceptive or to visual cuing. The stimulated left hand located in the left space may act as a powerful visual cue for the enhancement of the left visuo-spatial representation, in the same way as any other visual stimulus presented in the periphery of the visual field. Alternatively, it may be that the perceived hand location (due to the activation of the proprioceptive system) acts as an attentional field able to enhance the representation of the left space. In order to disentangle these two hypotheses, in the present study a naming task was executed by a group of neglect patients and by a control group. The subjects had to name all the objects depicted on a sheet of paper which were reflected on a mirror that inverted right and left space. While doing the naming performance, the subjects passively moved either the right or the left hand, in the left or right space. Stimuli and hand were reflected in the mirror that inverted right and left space and direct view of the stimuli and of the stimulated hand was prevented by a board. The results show that patients were more accurate at naming stimuli reflected in the left side of the mirror when the left hand was located and moved on the left side. In this condition, however, the left hand was seen in the right side of the mirror. It is therefore clear that the better performance was not due to visuo-spatial cuing but to a proprioceptive cuing effect. The results are discussed in terms of the relevance of personal and peripersonal spatial activation in the modulation of extrapersonal visual neglect. The coactivation of different spatial representations seems to be very influential on stimulus coding, thus confirming that spatial awareness is strictly related to the joint activity of multiple brain maps.

Aged↗
PubMed1997

Preserved semantic access in neglect dyslexia.

The aim of this study was to investigate the preservation of semantic access in patients with severe neglect dyslexia for words and non-words. Patients were given the following tasks: (1) reading aloud letter strings (first basic reading task), (2) making semantic decisions (categorial and inferential judgements), (3) making semantic decisions and reading the letter strings immediately afterwards (semantic-reading tasks), (4) reading letter strings again (final basic reading tasks) and (5) auditory control tasks. Of 23 patients with visual neglect, four showed neglect dyslexia for both words and non-words. Of these four patients, three showed a performance in the semantic tasks that was as good as in the auditory condition. Moreover, the reading of the patients improved dramatically in the semantic-reading tasks but this was not maintained in the final basic reading task. Non-words showed only a minor improvement. Findings are discussed in terms of an interaction between the attentional system and the different reading routes, and provide evidence that semantic routes are less affected by neglect.

Aged↗
PubMed1997

Lexical and semantic processing in the absence of word reading: evidence from neglect dyslexia.

Nine patients with left-sided neglect and nine matched control patients performed three tasks on horizontal (either normal or mirror-reversed) letter strings. The tasks were: reading aloud, making a lexical decision (word vs non-word), and making a semantic decision (living vs non-living item). Relative to controls, neglect patients performed very poorly in the reading task, whereas they performed nearly normally in the lexical and semantic tasks. This was considered to be a dissociation between direct tasks, rather than a dissociation between explicit and implicit knowledge. The explanation offered for the dissociation is in terms of both a dual-route model for reading aloud and a degraded representation of the letter string.

Aged↗
PubMed1996

Anosognosia for hemiplegia, neglect dyslexia, and drawing neglect: clinical findings and theoretical considerations.

In this paper different models of anosognosia are confronted and data concerning denial behaviors are presented that were collected on a selected population of right brain-damaged patients affected by motor and neglect disorders. Anosognosia for motor impairment and anosognosia for cognitive impairments were found to be dissociated, as well as anosognosia for the upper and lower limb motor impairments. These findings are then discussed in an attempt to choose the more suitable theoretical framework for interpreting the various disorders related to denial of illness.

Aged↗
PubMed1994

Automatic and voluntary orienting of attention in patients with visual neglect: horizontal and vertical dimensions.

The present study was aimed at testing internally and externally-controlled mechanisms of covert orienting in patients with visuo-spatial neglect. Internally-controlled orienting was tested by presenting central informative cues. Externally-controlled orienting was tested by presenting peripheral non-informative cues. We also tested for the presence of vertical neglect in patients with horizontal neglect, and tried to assess whether altitudinal neglect is an attentional deficit. Finally we examined whether altitudinal neglect manifests itself only in the visual field contralateral to the lesion or, as has been shown for horizontal neglect, whether it is also present in the ipsilesional visual field. The results showed that patients with neglect have a deficit of externally-controlled covert orienting in the visual field opposite to that of the lesion. Further, the impairment appeared to be more pronounced in the lower than in the upper visual field and to be mainly evident in the visual field contralateral to the lesion. The deficit could, however, be partially compensated for by the use of internally-controlled covert orienting. These findings seems to support the dual-mechanisms hypothesis which maintains that automatic and voluntary orienting are subserved by separate mechanisms possibly located in different parts of the brain.

Aged↗
PubMed1994

Neglect determined by the relative location of responses.

The aim of the present study was to assess the relevance of relative position coding of the effectors in the determination of neglect for the space of response. Two groups of patients were selected: an experimental group, consisting of right brain-damaged patients with left unilateral neglect, and a control group, consisting of right brain-damaged patients without unilateral neglect. These patients participated in two different experiments. In Experiment 1 the stimuli were horizontally aligned to the left and the right of a fixation stimulus; in Experiment 2 they were vertically aligned above and below the fixation stimulus. The stimuli consisted either of the number '1' or the number '2'. In both experiments, the patient was required to give a relative left key press response upon presentation of number '1' and a relative right key press response upon presentation of number '2'. The responses were recorded using the index and middle fingers of the right hand and the response keyboard was located on the right side of body midline. In each experiment there were two hand response conditions: standard and reversed. Under the former condition the hand was in the normal upright position; under the latter, the hand and the response keyboard were rotated by approximately 180 degrees. Under the standard condition, the two effectors were located on the typical anatomical spatial position, i.e. the index finger, which was located on the left relative position, pressed the left key, and the middle finger, which was located on the right relative position, pressed the right key. Under the reversed condition, the positions of the two effectors were reversed, i.e. the middle finger located on the left relative spatial position pressed the left key and the index finger, located on the right relative spatial position, pressed the right key. The results for both experiments showed that neglect patients were always slower to respond when the task required a left key response. The effect was manifest under both the standard and the reversed conditions. The neglect was therefore for the space of response and not for the anatomical spatial position of the effectors.

Adult↗