Biomedical subjects

Laure Pisella

Publications and source records attributed to Laure Pisella.

13 recordsLinked to original sources

PubMed2006

Prism adaptation in the rehabilitation of patients with visuo-spatial cognitive disorders.

PURPOSE OF REVIEW: The traditional focus of neurorehabilitaion has been on the patients' attention on their deficit, such that they should become aware of their problems and gain intentional control of compensatory strategies (descending approach). We review prism adaptation as one of the approaches that emphasize ascending rather than descending strategies to the rehabilitation of visuo-spatial disorders. The clinical outcome of prism adaptation highlights the need for a theoretical reconsideration of some previous stances to neurological rehabilitation. RECENT FINDINGS: Recent years have given rise to a growing body of experimental studies showing that the descending strategy is not always optimal, especially when higher-level cognition is affected by the patients' condition. Ascending approaches have, for example, used visuo-manual adaptation for the rehabilitation of visuo-spatial deficits. A simple task of pointing to visual targets while wearing prismatic goggles can produce remarkable improvements of various aspects of unilateral neglect. SUMMARY: The neural mechanisms underpinning visuo-manual plasticity can be viewed as a powerful rehabilitation tool that produces straightforward effects not only on visual and motor parameters, but on visuo-spatial, attentional and higher cognitive neurological functions. The use of prism adaptation therapy in neglect and other visuo-spatial disorders has just started to reveal its potential, both at a practical and theoretical level.

Adaptation, Physiological↗

PubMed2006

Neglect and prism adaptation: a new therapeutic tool for spatial cognition disorders.

PURPOSE: A large proportion of right-hemisphere stroke patients show unilateral neglect, a neurological deficit of perception, attention, representation, and/or performing actions within their left-sided space, inducing many functional debilitating effects on everyday life, and responsible for poor functional recovery and ability to benefit from treatment. This spatial cognition disorder affects the orientation of behaviour with a shift of proprioceptive representations toward the lesion side. METHODS: This shift can be reduced after a prism adaptation period to a right lateral displacement of visual field (induced by a simple target-pointing task with base-left wedge prisms). The modification of visuo-motor or sensory-motor correspondences induced by prism adaptation involves improvement of different symptoms of neglect. RESULTS: Classical visuo-motor tests could be improved for at least 2h after adaptation, but also non-motor and non-visual tasks. In addition, cross-modal effects have been described (tactile extinction and dichotic listening), mental imagery tasks (geographic map, number bisection) and even visuo-constructive disorders. These cognitive effects are shown to result from indirect bottom-up effects of the deeper, adaptive realignment component of the reaction to prisms. Lesion studies and functional imaging data evoke a cerebello-cortical network in which each structure plays a specific role and not all structures are crucial for adaptation ability. CONCLUSIONS: These cognitive effects of prism adaptation suggest that prism adaptation does not act specifically on the ipsilesional bias characteristic of unilateral neglect but rehabilitates more generally the visuo-spatial functions attributed to the right cortical hemisphere. These results reinforce the idea that the process of prism adaptation may activate brain functions related to multisensory integration and higher spatial representations and show a generalization at a functional level. Prism adaptation therefore appears as a new powerful therapeutic tool for spatial cognition disorders.

Adaptation, Physiological↗

PubMed2005

Impairment of gaze-centered updating of reach targets in bilateral parietal-occipital damaged patients.

Recent studies have suggested that internal updating of visuospatial targets in humans occurs in gaze-centered coordinates and takes place in the parietal and extrastriate cortices. We explored how information for reaching is updated in two patients with bilateral lesions in these areas. Subjects performed two visuomotor tasks: (i) a fixation reaching task, which began with the appearance of one of five fixation positions (varying eye positions) followed by a central reaching target. Subjects reached to the target while fixating on the presented fixation position (relative to gaze the target was always presented in the periphery); and (ii) a saccade reaching task, in which subjects foveated on the central reaching target, then made a saccade to the presented fixation position before reaching to the central target. In both tasks, subjects reached to targets after a 500 or 5000 ms delay. Gaze-centered updating predicts similarities in reaching errors between fixation and saccade trials. Control subjects showed evidence for gaze-centered updating during both 500 and 5000 ms delay conditions. In contrast, patient AT, who had extensive occipital-parietal damage, only showed signs of gaze-centered representation after 5 s. Patient IG, with a more focal lesion in the parietal cortices, showed partial updating in gaze-centered coordinates when reaching with the small memory delay but recovered a complete gaze-centered representation after the longer delay. This suggests that patients with bilateral occipital-parietal lesions may rely on non-gaze-centered frames to store immediate target locations in reaching space but, given enough time, this information may be rerouted to access other gaze-centered motor cortical mechanisms.

Adult↗

PubMed2004

Prismatic adaptation reduces biased temporal order judgements in spatial neglect.

Visuomotor adaptation to rightward-deviating optical-wedge prisms reduces the clinical manifestations of spatial neglect after right hemisphere damage. We investigated whether this beneficial effect of prism adaptation is due to attenuation of the ipsilesional attentional bias that is common in spatial neglect. Five right hemisphere patients performed visual temporal order judgements before and after visuomotor adaptation to 15 degrees rightward-deviating prisms. The magnitude of patients' ipsilesional attentional bias on the temporal order judgement task was significantly reduced following adaptation. By contrast, the temporal order judgements of normal participants did not change following adaptation to either leftward- or rightward-deviating prisms. The findings suggest that prism adaptation helps to rebalance the distribution of spatial attention following right hemisphere damage.

Adaptation, Physiological↗

PubMed2004

The contribution of spatial remapping impairments to unilateral visual neglect.

Left visual neglect following right hemisphere damage is a heterogeneous phenomenon, in which several underlying impairments have been identified. Despite recent advances in understanding the neural and cognitive bases of these impairments, current theories of neglect, particularly those that emphasise attentional deficits, do not explain a number of phenomena, including: 'Ipsilesional' neglect after left orienting. Positive or 'productive' manifestations. Spatial transposition errors. Mislocalisations. Revisiting behaviour during visual search. Lack of awareness for objects toward the contralesional side of space. We propose that these manifestations of neglect can be accounted for by an additional underlying disorder of spatial remapping due to parietal dysfunction. In primary visual areas, retinotopic maps are renewed and thus overwritten at each new ocular fixation. Remapping processes operating in higher-level oculocentric visual maps of the parietal cortex ensure visual integration of these successive retinal images over time and space, by creating a constantly updated representation of stimulus locations in terms of distance and direction from the fovea. They consist in the storage, refreshment and re-localization of the different components of the visual scene that are successively attended during its exploration, and provide spatial constancy of visual perception and a spatial buffer for working memory [Cereb Cortex 5 (1995) 470; Visual Cogn 7 (2000) 17]. We begin this article by reviewing theoretical and experimental arguments that have highlighted the importance of parietal remapping processes in maintaining an accurate representation of space across saccadic shifts. We then focus on findings from the double-step saccade task, [Ann Neurol 38 (1995) 739] as a basis for our model of the role of remapping impairments in many of the symptoms of neglect. From these results, remapping impairments would be demonstrated when a saccade has to be guided across the midline after having fixated an object in either the left or right visual field for patients with either left- or right-side parietal lesions. In addition, patients with right-side lesions will have remapping impairments within the left visual field following a saccade to a left-side target (see Fig. 5). In a large part of the article, we seek to build our hypothesis based on this basic model and more speculative assumptions supported with extensive evidence from the literature.

Attention↗

PubMed2004

Impaired working memory for location but not for colour or shape in visual neglect: a comparison of parietal and non-parietal lesions.

Patients with spatial neglect due to right hemisphere pathology may show 'revisiting' behaviour during visual search and cancellation tasks, such that previously encountered targets are treated as if they are new discoveries. Revisiting behaviour is particularly evident when no visible trace is left to inform patients that a particular target has already been detected (Husain et al., 2001; Wojciulik et al., 2001), implying that spatial working memory may be impaired in neglect. To test whether working memory for location is selectively impaired relative to memory for colour and shape, we compared performances of right hemisphere neglect patients with parietal (n = 4) and non-parietal (n = 4) lesions on a change detection task. Patients were presented with a matrix containing four objects in different positions, and required to detect a change in the location, colour or shape of one of the objects following presentation of a brief visual mask. Parietal patients were selectively impaired in detecting location changes, regardless of the horizontal position of the object in the matrix, relative to colour and shape changes. This deficit of spatial working memory was not apparent for neglect patients with lesions that spared the parietal cortex. We conclude that the human parietal cortex is crucially involved in the updating and maintenance of spatial representations across saccades, and that neglect arising from parietal damage causes impairment in these re-mapping mechanisms.

Adult↗

PubMed2003

Optic ataxia revisited: visually guided action versus immediate visuomotor control.

Optic ataxia and visual agnosia have been proposed to constitute a double dissociation which provides the main argument for the assimilation of the anatomical distinction between a dorsal and a ventral visual stream to the functional distinction between perception and action. In the present review, we argue that insufficient evidence has been collected to argue for this double dissociation. Several criteria are reviewed: (1) exploration of the visuomotor behavior in central versus peripheral vision has not been matched for the two types of patients; (2) the temporal constraints of visual processes that are impaired in the two neurological conditions appear to play a crucial role in the apparent dissociation; (3) the necessary reductionism of experimental conditions used to study action has led to an overconsideration of optic ataxia as a global deficit for action. Altogether optic ataxia appears to result from a specific impairment of immediate visuomotor control rather than of visually guided action as a whole. These results are discussed in the light of recent research on optic ataxia and on motor control, and directions for future research are proposed.

Agnosia↗

PubMed2003

Simulating unilateral neglect in normals using prism adaptation: implications for theory.

Rightward deviation on line bisection is considered one of the most classic clinical signs of unilateral visual neglect--a cognitive disorder of spatial processing that commonly follows right brain damage. Recently, short-term adaptation to wedge prisms has been shown to significantly reduce neglect on this and other conventional diagnostic tasks. Our previous study has shown that visuomotor adaptation in normals produces a similar pattern of directional bias on a line bisection task. Based on the good working knowledge of how neglect patients perform on different versions of the standard diagnostic task, we showed here that using leftward-deviating prisms in normals, it is possible to produce: (1) a reliable bias on line bisection, (2) a rightward specific deviation, (3) a modulation of rightward deviation, which depends on the relative spatial location of the target lines and (4) a line length effect. A final experiment confirmed that these after-effects are specific to prism adaptation rather than passive prism exposure. Collectively, these findings confirm that adaptation to left-deviating prisms in normals produces a reliable right-sided bias and as shown by a previous visuospatial judgement task, these findings cannot be adequately explained by the symmetric sensori-motor effects of prism adaptation. Taken together with the improvement of spatial neglect shown by right-deviating prisms only, the present study suggests that low level sensori-motor adaptations play a greater role in right hemisphere organisation for spatial cognition than previously thought.

Adaptation, Physiological↗

PubMed2003

Measuring unconscious actions in action-blindsight: exploring the kinematics of pointing movements to targets in the blind field of two patients with cortical hemianopia.

We tested two patients with posterior cerebral lesions on two pointing tasks. In the first task, the patients pointed to targets presented on a touch screen monitor and pointing accuracy was recorded. One patient (JR) demonstrated good localisation of targets presented to her blind field while the other patient (YP) did not. Movement kinematics were measured in the second task to compare the kinematics of movements made to sighted field targets with those made to blind field targets. For this version of the task both patients demonstrated above chance localisation of blind field targets although the slope of the relationship between the end of pointing movements and the target locations was significantly steeper for JR than for YP. Furthermore, JR showed a kinematic profile for movements made to blind field targets that mirrored the profile of kinematics to sighted field targets. That is, both peak velocity and time to peak velocity increased with increasing target eccentricity for movements made to blind and sighted field targets alike. Although patient YP now showed more reliable spatial localisation on this pointing task when compared with the touch screen task, his kinematics for movements made to targets in his blind field were quite different from those made to targets in his sighted field. Based on the patients' CT scans, we suggest that the superior performance of patient JR is a consequence of greater sparing of her parietal cortex in the damaged hemisphere.

Adult↗

PubMed2003

Bottom-up transfer of sensory-motor plasticity to recovery of spatial cognition: visuomotor adaptation and spatial neglect.

A large proportion of right-hemisphere stroke patients show hemispatial neglect, a neurological deficit of perception, attention, representation, and/or performing actions within their left-sided space, inducing many functional debilitating effects on everyday life, and responsible for poor functional recovery and ability to benefit from treatment. This spatial cognition disorder affects the orientation of behavior with a shift of proprioceptive representations toward the lesion side. This shift is similar to that produced by psychophysical manipulations as a wedge-prism exposure in normal healthy subjects. In both subjects, one major compensative effect of short-term prism adaptation is a shift of proprioceptive representations, demonstrated by a shift in manual straight-ahead pointing in the dark, in a direction opposite to the visual shift. In neglect patients, prism adaptation involves the shift of proprioceptive representations to the left with a reduction of rightward bias observed in neglect patients in visuo-manual tasks as line-bisection, line-cancellation or copy drawing. Improvement of neglect is also observed in no visuo-manual tasks as mental imagery, auditory extinction or posture. This generalization of prism adaptation effects at different neglect level symptoms suggests that the process of prism adaptation may activate brain functions related to multisensory integration and higher spatial representations. Moreover the positive effects found for both sensorimotor and more cognitive spatial functions lasted for at least two or more hours after prism removal. Unlike reduction of neglect through sensory stimulations, the long-lasting improvement of neglect after prism adaptation suggests the activation of short-term plasticity of brain functions related to coordinate transformations and space representations. Lastly, the duration of these effects could be useful in rehabilitation programs, as suggested by the effects of prism adaptation on disabling neglect symptoms as wheelchair driving, posture or writing.

Adaptation, Physiological↗

PubMed2002

Dissociated long lasting improvements of straight-ahead pointing and line bisection tasks in two hemineglect patients.

In this experiment, we evaluated over a longer time period the previously demonstrated effects of a short prism adaptation on hemispatial neglect. We followed two patients (PE and SA), during a period of 5 days (1 day before and 4 days after the prism adaptation procedure), repeatedly measuring their performances on a straight-ahead pointing task and a line bisection task. We also assessed the comparative temporal evolution of the rightward biased egocentric reference frame (as measured by the straight-ahead demonstration) and a classical neuropsychological symptom of neglect, namely the rightward bias observed on line bisection. Firstly, the results showed that prismatic effect could be maintained for 4 days, on the two tasks (separately straight-ahead for PE, line bisection for SA). This long-term effect implies a very profound action of prism adaptation based on active processes and opens large possibilities for clinical applications. Secondly, no correlation was found between the evolution of the performances on the two tasks, neither for patient PE, nor for patient SA (within-subject double-dissociation). Moreover, a double-dissociation between subjects was demonstrated on long-term effects. A new conception has thus to be found to explain the various symptoms manifested in neglect and more investigations have to be performed in order to establish to what extent they can be considered independent. It can be concluded that elucidating the mechanism through which prism adaptation affects neglect could lead to a better understanding of the neglect syndrome.

Adaptation, Psychological↗

PubMed2002

A lesion of the posterior parietal cortex disrupts on-line adjustments during aiming movements.

It is long known that the posterior parietal cortex (PPC) is critically involved in goal-directed movements. Nevertheless, there are still some controversies about its specific functions. Although most published studies have emphasised the role of PPC in sensorimotor planning processes, it has been recently suggested that PPC can also participate to on-line movement control. We studied kinematics of hand movements in a patient with a bilateral PPC lesion who exhibited no deficit in planning of her grasping movements in central vision. She was instructed to reach and grasp a cylinder presented at different locations and her motor performance was compared to that of four healthy control subjects. To address on-line control specifically, the cylinder was quickly and unexpectedly jumped, on a few trials, at movement onset, to a new location some 10 degrees (of apparent visual angle) from the original location. The patient could easily grasp stationary objects seen in foveal vision, exhibiting the same kinematic pattern as controls. Therefore, she could plan movements accurately. In response to the object jump, unlike the controls, the patient was unable to amend her ongoing movement. In this situation, she completed two distinct movements, a first one toward the initial object location and a second one toward the final object location. These results support the hypothesis that beyond a role in movement planning, PPC plays a major role in the on-line control of reach-to-grasp movements.

Adult↗

PubMedDate not supplied

Prism adaptation and spatial attention: a study of visual search in normals and patients with unilateral neglect.

Visuomotor adaptation to a prism-induced lateral displacement of the visual field induces mild perceptual biases in healthy individuals and improves symptoms of unilateral neglect. The present study employed a speeded visual search task to test the hypothesis that prism adaptation induces an adaptive redistribution of selective spatial attention. In Experiment 1, 32 neurologically healthy, right-handed participants were adapted to a 150 prism-induced lateral (left or right) displacement of the visual field. Spatial attention was measured by search time and error-rate in unique-feature ("preattentive") and feature-absent ("serial") visual search tasks, before and after prism adaptation. The single target appeared at different locations within arrays of 12, 24 or 48 items. Contrary to the attentional hypothesis, the pattern of search performance across the display remained unchanged following prism adaptation. In Experiment 2, we tested four patients with unilateral right hemisphere damage on the visual search tasks, before and after adaptation to 15 degrees rightward-displacing prisms. All four patients showed a pathological gradient of spatial attention toward the ipsilesional side prior to adaptation. Consistent with the results from Experiment 1, the gradient in search performance shown by the patients did not change following prism adaptation. Taken together, these findings suggest that the perceptual aftereffects in normals and amelioration of unilateral neglect following prism adaptation are not mediated by an adaptive redistribution of spatial attention.

Adaptation, Psychological↗