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Biomedical subjects

Paolo Bartolomeo

Publications and source records attributed to Paolo Bartolomeo.

At least 19 recordsLinked to original sources
PubMed2007

Impaired orienting of attention in left unilateral neglect: a componential analysis.

Twenty-six patients suffering from damage to the right side of the brain, 19 of whom exhibited signs of left neglect, as well as 32 matched controls, ran 3 spatial cuing tasks. Patients were also tested with 2 cancellation tests, a line-bisection test, the copy of a complex drawing, and a visual extinction procedure. Results first showed correlations between extinction and cancellation tests performance on one hand, and between line bisection and copy on the other hand. Second, results demonstrated that an engagement deficit toward contralesional targets appeared to be the most striking feature of neglect, and the engagement score was correlated with the cancellation score and extinction. Most patients with neglect also presented a deficit in disengagement, a deficit of inhibition of return, and probably a deficit of alertness. Deficits in engagement and in disengagement, as well as poor scores in cancellation tests, seemed to be related with posterior cortical and subcortical lesions. Most important, even if an endogenous deficit (frequently related with a thalamic lesion) could aggravate the neglect behavior, neglect syndrome was mainly explained by a deficit of exogenous attention.

Aged↗
PubMed2006

The phenomenology of endogenous orienting.

Can we build endogenous expectations about the locus of occurrence of a target without being able to describe them? Participants performed cue-target detection tasks with different proportions of valid and invalid trials, without being informed of these proportions, and demonstrated typical endogenous effects. About half were subsequently able to correctly describe the cue-target relationships ('verbalizers'). However, even non-verbalizer participants showed endogenous orienting with peripheral cues (Experiments 1 and 3), not depending solely on practice (Experiment 2). Explicit instructions did not bring about dramatic advantages in performance (Experiment 4). With central symbolic cues, only verbalizers showed reliable endogenous effects (Experiment 5). We concluded that endogenous orienting with peripheral cues can occur independently of participants developing explicit hypotheses about the cue-target relationships.

Adult↗
PubMed2006

Cognitive impairment related to apathy in early Huntington's disease.

OBJECTIVE: To investigate the relationships between cognitive impairment and apathy in patients with early Huntington's disease (HD) and to further explore the influence of depression on the outcome of cognitive changes associated with apathy. METHODS: We included 36 early HD patients, among them 20 were apathetic (HDA) and 16 were not (HDnA). The two groups were matched by age, education and severity of disease. Cognitive functions were evaluated by a comprehensive neuropsychological battery that measures memory, attention, executive function, language and visuospatial abilities. RESULTS: The HDA patients had significantly lower scores on memory, attention and executive function tests when compared with the HDnA patients (p values <0.05). We compared the performance of patients with (50%) and without depression on cognitive tasks and showed that depression per se did not influence performance. Finally, the results demonstrate that interactions between apathy and motor disturbance have a significant effect on cognitive impairment in HD. DISCUSSION: The presence of apathy is associated with more severe deficits of attention, executive function and episodic memory in early HD patients. Furthermore, the findings suggest that depression has little or no effect on cognitive deficits. Finally, apathy increased in parallel with both motor and cognitive dysfunction.

Adult↗
PubMed2006

A battery of tests for the quantitative assessment of unilateral neglect.

PURPOSE: The lack of agreement regarding assessment methods is responsible for the variability in the reported rate of occurrence of unilateral neglect (UN) after stroke. In addition, dissociations have been reported between performance on traditional paper-and-pencil tests and UN in everyday life situations. METHODS: In this paper, we present the validation studies of a quantitative test battery for UN, including paper-and-pencil tests, an assessment of personal neglect, extinction, and anosognosia, and a behavioural assessment, the Catherine Bergego Scale (CBS). The battery was given to healthy subjects (n=456-476) and to patients with subacute stroke, either of the right or the left hemisphere. RESULTS: In healthy subjects, a significant effect of age, education duration and acting hand was found in several tasks. In patients with right hemisphere stroke, the most sensitive paper and pencil measure was the starting point in the cancellation task. The whole battery was more sensitive than any single test alone. An important finding was that behavioural assessment was more sensitive than any other single test. Neglect was two to four times less frequent, but also less severe and less consistent after left hemisphere stroke. CONCLUSION: Assessment of UN should rely on a battery of quantitative and standardised tests. Some patients may show clinically significant UN in everyday life while obtaining a normal performance on paper-and-pencil measures. This underlines the necessity to use a behavioural assessment of UN.

Activities of Daily Living↗
PubMed2005

Direct evidence for a parietal-frontal pathway subserving spatial awareness in humans.

Intraoperative electrical stimulation, which temporarily inactivates restricted regions during brain surgery, can map cognitive functions in humans with spatiotemporal resolution unmatched by other methods. Using this technique, we found that stimulation of the right inferior parietal lobule or the caudal superior temporal gyrus, but not of its rostral portion, determined rightward deviations on line bisection. However, the strongest shifts occurred with subcortical stimulation. Fiber tracking identified the stimulated site as a section of the superior occipitofrontal fasciculus, a poorly known parietal-frontal pathway. These findings suggest that parietal-frontal communication is necessary for the symmetrical processing of the visual scene.

Adult↗
PubMed2005

Time to imagine space: a chronometric exploration of representational neglect.

When describing known places from memory, patients with left spatial neglect may mention more right- than left-sided items, thus showing representational, or imaginal, neglect. This suggests that these patients cannot either build or explore left locations in visual mental imagery. However, in place description there is no guarantee that patients are really employing visual mental imagery abilities, rather than verbal-propositional knowledge. Thus, patients providing symmetrical descriptions might be using other strategies than visual mental imagery. To address this issue, we devised a new test which strongly encourages the use of visual mental imagery. Twelve participants without brain damage and 12 right brain-damaged patients, of whom 7 had visual neglect, were invited to conjure up a visual mental image of the map of France. They subsequently had to state by pressing a left- or a right-sided key whether auditorily presented towns or regions were situated to the left or right of Paris on the imagined map. This provided measures of response time and accuracy for imagined locations. A further task, devised to assess response bias, used the words "left" or "right" as stimuli and the same keypress responses. Controls and non-neglect patients performed symmetrically. Neglect patients were slower for left than for right imagined locations. On single-case analysis, two patients with visual neglect had a greater response time asymmetry on the geographical task than predicted by the response bias task, but with symmetrical accuracy. The dissociation between response times and accuracy suggests that, in these patients, the left side of the mental map of space was not lost, but only "explored" less efficiently.

Adult↗
PubMed2004

Independent effects of endogenous and exogenous spatial cueing: inhibition of return at endogenously attended target locations.

Inhibition of return (IOR) is thought to reflect a bias against returning attention to previously attended locations. According to this view, IOR should occur only if attention is withdrawn from the target location prior to target appearance. In the present study, endogenous attention and exogenous cueing were manipulated orthogonally. IOR was observed both when a target appeared at an unexpected location, and when a target appeared at the expected location. A similar pattern of results was obtained in a reanalysis of data from a study with Neglect patients. These results suggest that IOR is independent of endogenous orienting.

Adult↗
PubMed2004

Active versus passive proprioceptive straight-ahead pointing in normal subjects.

Eighty blindfolded healthy female subjects participated in an active and a passive straight-ahead pointing task to study the estimation of the subjective sagittal middle in the presence or absence of an active haptic exploration. Subjects were to point straight-ahead with their left or right index finger starting from different right- or left-sided locations, while performing either an active movement or with the hand being passively moved by the examiner. Results showed: (i) a significant effect of the hand used only on the active straight-ahead pointing task performance; (ii) a significant effect of the starting position both on the active and passive pointing performance; (iii) a significant correlation between the two protocols only in terms of spatial bias (algebraic error) but not in terms of precision (absolute errors). These results are discussed with regards to normal and neuropsychological studies of the egocentric frame of reference.

Adult↗
PubMed2004

The role of vision in spatial representation.

A complex link exists between vision and unilateral spatial neglect (USN). Firstly, USN is not a perceptual deficit, secondly, USN is not necessarily accompanied by a visual deficit and finally, USN can be observed in non-visual modalities as well as in mental spatial imagery. This apparent supramodality of USN stands in sharp contrast to the fact that neglect signs are often more severe and more durable in the visual than in other sensory modalities (Chokron et al., 2002). The influence of vision on spatial representation has rarely been studied. In the present study we assessed six right brain-damaged patients suffering from left USN on two tasks involving spatial representations: a clock-drawing task and a drawing from memory task in two experimental conditions, with and without visual control. We confirm that even in mental imagery, the absence of visual feedback may decrease and even suppress left neglect signs (Bartolomeo and Chokron, 2001b; 2002). Since vision is largely involved in the orientation of attention in space, suppressing visual control could reduce the magnetic attraction towards the right ipsilesional hemispace and in this way could allow a re-orientation of attention towards the left neglected hemispace. We discuss the theoretical and therapeutic implications of these findings.

Adult↗
PubMed2004

Neglected attention in apparent spatial compression.

Halligan and Marshall [Cortex 27 (1991) 623] devised a new test to evaluate the hypothesis that in visual neglect, left space is systematically compressed rightwards. In the critical condition of the original study, rows of horizontally arranged numbers with a target arrow pointing to one of them from the opposite margin of the display were presented. When asked to verbally identify the number indicated by the arrow, a right brain-damaged patient with left neglect and hemianopia often indicated a number to the right of the target. The more the target was located on the left, the greater the response shift rightward, as if rightward compression were linearly proportional to the co-ordinates of Euclidian space. However, a possible alternative account could be that the patient's attention was attracted by the numbers located to the right of the target digit, thus biasing her responses toward numbers on the right. To explore this hypothesis, we asked normal participants and patients with right hemisphere lesions, with and without neglect or hemianopia, to mark on the margin of a sheet the approximate location indicated by an arrow situated on the opposite margin. In three different conditions, the arrow indicated either one of several numbers or lines in a row, or a blank location on the sheet margin. Only patients with left neglect, and especially those with associated hemianopia, deviated rightward, and then crucially only on those conditions where visible targets were present, consistent with the attentional bias account.

Adult↗
PubMed2003

Selective attention, inhibition for repeated events and hemispheric specialization.

When two visual events appear consecutively in the same spatial location, our response to the second event is slower than to the first. This inhibition for repeated events may reflect a bias toward sampling novel locations, a bias useful for exploring visual space. It has been shown that the left hemisphere is more specialized in selective attentional processes than the right one. The aim of the present experiment was to test if this hemispheric specialization for selective attention may also affect the inhibition for repeated events. For this purpose, we asked 11 normal subjects to perform an identity-based discrimination task in which the target to be detected could appear alone or surrounded by flanking letters, in the left or in the right visual field. Results show that inhibition for repeated events is present only when selective attention is required and when the task is performed in the right specialized visual field.

Adult↗
PubMed2003

Mechanisms of pure alexia: spatially based impairment, letter identification deficit, or both?

We studied reading performance for words and for isolated letters in a pure alexic patient. She performed reasonably well when naming isolated letters but was slower in reading letters than a control subject when reaction times (RTs) were recorded. When the patient read isolated letters, RTs were slower for a subset of letters that cannot be recognized from their left part alone (e.g. "b", an ambiguous letter, could be read "b" "h" "l" or "k" whereas "a" has no predictable confounders). We observed a significant positive correlation between the RTs for reading a word and the mean RTs for reading each of its composing letters before its uniqueness point (i.e. the point, when reading from the left to the right, where a word cannot be a word other than the one it is). This result suggests that, in our patient, the letter identification deficit can account for the slow, letter-by-letter reading behaviour, insofar as each letter represents a perceptual problem. Our findings can be accounted for by a deficit in the parallel processing of the left and right parts of each letter, compounded with a bias to process first the left part of the letter, and may thus reconcile the hypotheses of spatially-based deficit (Rapp and Caramazza, 1991) and of a perceptual deficit occurring at the letter identification level (Behrmann and Shallice, 1995; Perri et al., 1996).

Aged↗
PubMed2002

The relationship between visual perception and visual mental imagery: a reappraisal of the neuropsychological evidence.

Visual perception and visual mental imagery, the faculty whereby we can revisualise a visual item from memory, have often been regarded as cognitive functions subserved by common mechanisms. Thus, the leading cognitive model of visual mental imagery holds that visual perception and visual imagery share a number of mental operations, and rely upon common neural structures, including early visual cortices. In particular, a single visual buffer would be used "bottom-up" to display visual percepts and "top-down" to display internally generated images. The proposed neural substrate for this buffer consists of some cortical visual areas organised retinotopically, that is, the striate and extrastriate occipital areas. Empirical support for this model came from the report of brain-damaged patients showing an imagery deficit which parallels a perceptual impairment in the same cognitive domain. However, recent reports of patients showing double dissociations between perception and imagery abilities challenged the perception-imagery equivalence hypothesis from the functional point of view. From the anatomical point of view, the available evidence suggests that occipital damage is neither necessary nor sufficient to produce imagery deficits. On the other hand, extensive left temporal damage often accompanies imagery deficits for object form or colour. Thus, visual mental imagery abilities might require the integrity of brain areas related to vision, but at an higher level of integration than previously proposed.

Brain Damage, Chronic↗
PubMed2002

Visually- and motor-based knowledge of letters: evidence from a pure alexic patient.

We describe a patient, VSB, whose reading was impaired as a consequence of a left temporal-parietal lesion, whereas writing was relatively preserved. At variance with other pure alexic patients described in the literature, VSB claimed to have become unable to mentally visualise letters and words. Indeed, his performance on a series of tests tapping visual mental imagery for orthographic material was severely impaired. However, performance on the same tests was dramatically ameliorated by allowing VSB to trace each item with his finger. Visual mental imagery for non-orthographic items was comparatively spared. The pattern of dissociation shown by VSB between impaired visual mental imagery and relatively preserved motor-based knowledge for orthographic material lends support to the view that separate codes, respectively based on visual appearance and on motor engrams, may be used to access knowledge of the visual form of letters and words.

Alexia, Pure↗
PubMed2002

Visual, proprioceptive and tactile performance in left neglect patients.

Patients with unilateral spatial neglect due to right-hemisphere lesions typically fail to attend to and explore left-sided stimulus objects. It has been postulated that in right-brain damaged (RBD) patients an ipsilesional displacement of the egocentric frame of reference (ER), whether visual or tactile, may be responsible for a contralesional supramodal spatial bias causing their left neglect behavior. However, this hypothesis had been proposed without testing, in the same patients, the position of the ER or their performance in the visual and tactile modalities. Thus, the aim of the present study was to test the hypothesis that an ipsilateral shift of the ER is responsible for a supramodal spatial bias in neglect. For this purpose, a within-subject design is required. Consequently, 12 left neglect patients and 12 control subjects were asked to perform a proprioceptive straight-ahead pointing task while blindfolded, as well as visual and tactile bisection tasks. In the left neglect patients, we found:no systematic deviation of the ER on the ipsilesional right side;a significant rightward bias in visual bisection, and normal performance in tactile bisection;no correlation among the three tasks;that only visual bisection correlated with the severity of neglect. These results are discussed with regard to the egocentric and attentional hypothesis of neglect.

Aged↗