Search

Background: Previous studies have demonstrated that naming treatments can improve language abilities in people with aphasia (PWA). However, there is currently a lack of protocols for evidencebased naming treatment in Hebrew. Aims: This study aims to evaluate the efficacy of a novel morphology-based naming treatment for Hebrew-speaking PWA and to investigate subject-related factors influence responsiveness to the treatment. Method & Procedures: Twelve chronic stroke PWA and moderate to severe anomia participated in 20 treatment sessions focused on the root-structure morphology of Hebrew. Treatment stimuli incorporated morphologically complex words comprising root and template. Treatment effects were assessed at both subject level and group level. Outcomes & Results: The treatment showed promising results, with a significant increase in correct naming for both treated and untreated complex words. These gains were maintained for at least 10 weeks post-treatment. Most of the benefit was achieved during the first 10 treatment sessions. Additionally, the group demonstrated generalization effects to naming simple words. Pre-treatment performance in naming morphologically complex words predicted higher treatment gains during the follow-up session, irrespective of word type. Conclusions: These findings provide preliminary evidence supporting the efficacy of root-based naming treatment for Hebrew-speaking PWA. Future research should compare this treatment to an untreated control group and to other treatment methods in Hebrew speakers to further validate its benefits. [ABSTRACT FROM AUTHOR]

Understanding the impact of variation in lesion topography on the expression of functional impairments following stroke is important, as it may pave the way to modeling structure–function relations in statistical terms while pointing to constraints for adaptive remapping and functional recovery. Multi‐perturbation Shapley‐value analysis (MSA) is a relatively novel game‐theoretical approach for multivariate lesion‐symptom mapping. In this methodological paper, we provide a comprehensive explanation of MSA. We use synthetic data to assess the method's accuracy and perform parameter optimization. We then demonstrate its application using a cohort of 107 first‐event subacute stroke patients, assessed for upper limb (UL) motor impairment (Fugl‐Meyer Assessment scale). Under the conditions tested, MSA could correctly detect simulated ground‐truth lesion‐symptom relationships with a sensitivity of 75% and specificity of ~90%. For real behavioral data, MSA disclosed a strong hemispheric effect in the relative contribution of specific regions‐of‐interest (ROIs): poststroke UL motor function was mostly contributed by damage to ROIs associated with movement planning (supplementary motor cortex and superior frontal gyrus) following left‐hemispheric damage (LHD) and by ROIs associated with movement execution (primary motor and somatosensory cortices and the ventral brainstem) following right‐hemispheric damage (RHD). Residual UL motor ability following LHD was found to depend on a wider array of brain structures compared to the residual motor ability of RHD patients. The results demonstrate that MSA can provide a unique insight into the relative importance of different hubs in neural networks, which is difficult to obtain using standard univariate methods. [ABSTRACT FROM AUTHOR]

Modalities for rehabilitation of the neurologically affected upper-limb (UL) are generally of limited benefit. The majority of patients seriously affected by UL paresis remain with severe motor disability, despite all rehabilitation efforts. Consequently, extensive clinical research is dedicated to develop novel strategies aimed to improve the functional outcome of the affected UL. We have developed a novel virtual-reality training tool that exploits the voluntary control of one hand and provides real-time movement-based manipulated sensory feedback as if the other hand is the one that moves. The aim of this study was to expand our previous results, obtained in healthy subjects, to examine the utility of this training setup in the context of neuro-rehabilitation. We tested the training setup in patient LA, a young man with significant unilateral UL dysfunction stemming from hemi-parkinsonism. LA underwent daily intervention in which he intensively trained the non-affected upper limb, while receiving online sensory feedback that created an illusory perception of control over the affected limb. Neural changes were assessed using functional magnetic resonance imaging (fMRI) scans before and after training. Training-induced behavioral gains were accompanied by enhanced activation in the pre-frontal cortex and a widespread increase in resting-state functional connectivity. Our combination of cutting edge technologies, insights gained from basic motor neuroscience in healthy subjects and well-known clinical treatments, hold promise for the pursuit of finding novel and more efficient rehabilitation schemes for patients suffering from hemiplegia. Assistive devices used in hospitals to support patients with hemiparesis require expensive equipment and trained personnel – constraining the amount of training that a given patient can receive. The setup we describe is simple and can be easily used at home with the assistance of an untrained caregiver/family member. Once installed at the patient's home, the setup is lightweight, mobile, and can be used with minimal maintenance. Building on advances in machine learning, our software can be adapted to personal use at homes. Our findings can be translated into practice with relatively few adjustments, and our experimental design may be used as an important adjuvant to standard clinical care for upper limb hemiparesis. [ABSTRACT FROM AUTHOR]

Motor recovery of the upper limb (UL) is related to exercise intensity, defined as movement repetitions divided by minutes in active therapy, and task difficulty. However, the degree to which UL training in virtual reality (VR) applications deliver intense and challenging exercise and whether these factors are considered in different centres for people with different sensorimotor impairment levels is not evidenced. We determined if (1) a VR programme can deliver high UL exercise intensity in people with sub-acute stroke across different environments and (2) exercise intensity and difficulty differed among patients with different levels of UL sensorimotor impairment. Participants with sub-acute stroke (<6 months) with Fugl-Meyer scores ranging from 14 to 57, completed 10 ∼ 50-min UL training sessions using three unilateral and one bilateral VR activity over 2 weeks in centres located in three countries. Training time, number of movement repetitions, and success rates were extracted from game activity logs. Exercise intensity was calculated for each participant, related to UL impairment, and compared between centres. Exercise intensity was high and was progressed similarly in all centres. Participants had most difficulty with bilateral and lateral reaching activities. Exercise intensity was not, while success rate of only one unilateral activity was related to UL severity. The level of intensity attained with this VR exercise programme was higher than that reported in current stroke therapy practice. Although progression through different activity levels was similar between centres, clearer guidelines for exercise progression should be provided by the VR application. VR rehabilitation systems can be used to deliver intensive exercise programmes. VR rehabilitation systems need to be designed with measurable progressions through difficulty levels. [ABSTRACT FROM AUTHOR]

The present research examines the effect of spatial (object-centered) attentional constraints on pattern recognition. Four normal subjects and two right-hemisphere-damaged patients with left visual neglect participated in the study. Small, letter-like, prelearned patterns served as stimuli. Short exposure time prevented overt scanpaths during stimulus presentation. Attention was attracted to a central (midsagittal) fixation point by precuing this location prior to each stimulus presentation. Minute (up to 1.5 ° of visual angle) rightward and leftward stimulus shifts caused attention to be allocated each time to a different location on the object space, while remaining in a fixed central position in viewer-centered coordinates. The task was to decide which of several prelearned patterns was presented in each trial. In the normal subjects, best performance was achieved when the luminance centroid (LC; derived from the analysis of low-spatial frequencies in the object space) of each pattern coincided with the spatial position of the precue. In contrast, the patients with neglect showed optimal recognition performance when precuing attracted attention to locations within the object space, to the left of the LC. The normal performance suggests that the LC may serve as a center of gravity for attention allocation during pattern recognition. This point seems to be the target location where focal attention is normally directed, following a primary global analysis based on the low spatial frequencies. Thus, the LC of a simple pattern may serve as the origin point for an object-centered-coordinate-frame (OCCF), dividing it into right and left. This, in turn, serves to create a prototype description of the pattern, in its own coordinates, in memory, to be addressed during subsequent recognition tasks. The best match of the percept with the stored description may explain the observed advantage of allocating attention to the LC. The performance of the brain-damaged patients can be explained in terms of neglect operating in the OCCF., INTRODUCTION One of the most intriguing consequences of focal damage to the human brain is unilateral spatial neglect (USN)-a failure to orient toward, respond to, and report on significant stimuli [...]