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Tatiana Ogourtsova - One of the best experts on this subject based on the ideXlab platform.
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post stroke Unilateral Spatial neglect virtual reality based navigation and detection tasks reveal lateralized and non lateralized deficits in tasks of varying perceptual and cognitive demands
Journal of Neuroengineering and Rehabilitation, 2018Co-Authors: Tatiana Ogourtsova, Philippe Archambault, Anouk LamontagneAbstract:Unilateral Spatial neglect (USN), a highly prevalent and disabling post-stroke impairment, has been shown to affect the recovery of locomotor and navigation skills needed for community mobility. We recently found that USN alters goal-directed locomotion in conditions of different cognitive/perceptual demands. However, sensorimotor post-stroke dysfunction (e.g. decreased walking speed) could have influenced the results. Analogous to a previously used goal-directed locomotor paradigm, a seated, joystick-driven navigation experiment, minimizing locomotor demands, was employed in individuals with and without post-stroke USN (USN+ and USN-, respectively) and healthy controls (HC). Participants (n = 15 per group) performed a seated, joystick-driven navigation and detection time task to targets 7 m away at 0°, ±15°/30° in actual (visually-guided), remembered (memory-guided) and shifting (visually-guided with representational updating component) conditions while immersed in a 3D virtual reality environment. Greater end-point mediolateral errors to left-sided targets (remembered and shifting conditions) and overall lengthier onsets in reorientation strategy (shifting condition) were found for USN+ vs. USN- and vs. HC (p < 0.05). USN+ individuals mostly overshot left targets (− 15°/− 30°). Greater delays in detection time for target locations across the visual spectrum (left, middle and right) were found in USN+ vs. USN- and HC groups (p < 0.05). USN-related attentional-perceptual deficits alter navigation abilities in memory-guided and shifting conditions, independently of post-stroke locomotor deficits. Lateralized and non-lateralized deficits in object detection are found. The employed paradigm could be considered in the design and development of sensitive and functional assessment methods for neglect; thereby addressing the drawbacks of currently used traditional paper-and-pencil tools.
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ecological virtual reality evaluation of neglect symptoms evens effects of virtual scene complexity in the assessment of poststroke Unilateral Spatial neglect
Neurorehabilitation and Neural Repair, 2018Co-Authors: Tatiana Ogourtsova, Philippe Archambault, Anouk Lamontagne, Samir SanganiAbstract:Background. Unilateral Spatial neglect (USN) is a highly prevalent and disabling poststroke impairment. USN is traditionally assessed with paper-and-pencil tests that lack ecological validity, generalization to real-life situations and are easily compensated for in chronic stages. Virtual reality (VR) can, however, counteract these limitations. Objective. We aimed to examine the feasibility of a novel assessment of USN symptoms in a functional shopping activity, the Ecological VR-based Evaluation of Neglect Symptoms (EVENS). Methods. EVENS is immersive and consists of simple and complex 3-dimensional scenes depicting grocery shopping shelves, where joystick-based object detection and navigation tasks are performed while seated. Effects of virtual scene complexity on navigational and detection abilities in patients with (USN+, n = 12) and without (USN−, n = 15) USN following a right hemisphere stroke and in age-matched healthy controls (HC, n = 9) were determined. Results. Longer detection times, larger me...
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let s do groceries a novel virtual assessment for post stroke Unilateral Spatial neglect
International Conference on Virtual Rehabilitation, 2017Co-Authors: Tatiana Ogourtsova, Philippe S Archambault, Anouk LamontagneAbstract:Background: Unilateral Spatial neglect (USN), a highly prevalent post-stroke impairment, has been strongly associated with poor functional outcomes in self-care and instrumental activities of daily living. Hence, its sensitive detection is crucial. Yet, conventional USN assessments present with significant limitations, often leading to misdiagnosis. Virtual reality (VR) can be used to counteract those issues and increase detection sensitivity. Objective: To examine the feasibility, refine development and promote future implementation of a novel Ecological VR-based Evaluation of Neglect Symptoms (EVENS). Methods: EVENS consists of two (simple and complex) immersive, 3-D scenes, depicting grocery shopping shelves, where object-detection and navigation tasks are performed using a joystick. Through a cross-sectional study, the effects of virtual scene complexity on navigational and detection abilities in patients with (USN+) and without (USN−) post-stroke USN and in healthy controls (HC) were determined. These findings were complimented by gathering the opinion of clinicians and experts in the field as to the barriers/facilitators to the use of VR and the features for an optimal assessment. Results: Longer detection times and larger mediolateral deviations from ideal paths were found in USN+ vs. USN− and HC groups. Several barriers/facilitators for clinical VR use and features of an optimal VR-based tool were identified. Conclusion: Navigation and detection abilities are affected by environmental complexity of the VR scene in individuals with post-stroke USN and can be employed for USN assessment. The present knowledge translation initiatives can refine EVENS' design and promote its future application and adherence to its use in clinical settings.
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virtual reality treatment and assessments for post stroke Unilateral Spatial neglect a systematic literature review
Neuropsychological Rehabilitation, 2017Co-Authors: Tatiana Ogourtsova, Philippe Archambault, Anouk Lamontagne, Wagner Souza SilvaAbstract:Unilateral Spatial neglect (USN) is a highly prevalent post-stroke deficit. Currently, there is no gold standard USN assessment which encompasses the heterogeneity of this disorder and that is sensitive to detect mild deficits. Similarly, there is a limited number of high quality studies suggesting that conventional USN treatments are effective in improving functional outcomes and reducing disability. Virtual reality (VR) provides enhanced methods for USN assessment and treatment. To establish best-practice recommendations with respect to its use, it is necessary to appraise the existing evidence. This systematic review aimed to identify and appraise existing VR-based USN assessments; and to determine whether VR is more effective than conventional therapy. Assessment tools were critically appraised using standard criteria. The methodological quality of the treatment trials was rated by two authors. The level of evidence according to stage of recovery was determined. Findings were compiled into a VR-based USN Assessment and Treatment Toolkit (VR-ATT). Twenty-three studies were identified. The proposed VR tools augmented the conventional assessment strategies. However, most studies lacked analysis of psychometric properties. There is limited evidence that VR is more effective than conventional therapy in improving USN symptoms in patients with stroke. It was concluded that VR-ATT could facilitate identification and decision-making as to the appropriateness of VR-based USN assessments and treatments across the continuum of stroke care, but more evidence is required on treatment effectiveness.
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impact of post stroke Unilateral Spatial neglect on goal directed arm movements systematic literature review
Topics in Stroke Rehabilitation, 2015Co-Authors: Tatiana Ogourtsova, Philippe Archambault, Anouk LamontagneAbstract:Background: Unilateral Spatial neglect (USN), a highly prevalent post-stroke impairment, refers to one's inability to orient or respond to stimuli located in the contralesional visual hemispace. Unilateral Spatial neglect has been shown to strongly affect motor performance in functional activities, including non-affected upper extremity (UE) movements. To date, our understanding of the effects of USN on goal-directed UE movements is limited and comparing performance of individuals post-stroke with and without USN is required.Objective: To determine, in individuals with stroke, how does the presence of USN, in comparison to the absence of USN, impacts different types of goal-directed movements of the non-affected UE.Methods: The present review approach consisted of a comprehensive literature search, an assessment of the quality of the selected studies and qualitative data analysis.Results: A total of 20 studies of moderate to high quality were selected. The USN-specific impairments were found in tasks that...
Anouk Lamontagne - One of the best experts on this subject based on the ideXlab platform.
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post stroke Unilateral Spatial neglect virtual reality based navigation and detection tasks reveal lateralized and non lateralized deficits in tasks of varying perceptual and cognitive demands
Journal of Neuroengineering and Rehabilitation, 2018Co-Authors: Tatiana Ogourtsova, Philippe Archambault, Anouk LamontagneAbstract:Unilateral Spatial neglect (USN), a highly prevalent and disabling post-stroke impairment, has been shown to affect the recovery of locomotor and navigation skills needed for community mobility. We recently found that USN alters goal-directed locomotion in conditions of different cognitive/perceptual demands. However, sensorimotor post-stroke dysfunction (e.g. decreased walking speed) could have influenced the results. Analogous to a previously used goal-directed locomotor paradigm, a seated, joystick-driven navigation experiment, minimizing locomotor demands, was employed in individuals with and without post-stroke USN (USN+ and USN-, respectively) and healthy controls (HC). Participants (n = 15 per group) performed a seated, joystick-driven navigation and detection time task to targets 7 m away at 0°, ±15°/30° in actual (visually-guided), remembered (memory-guided) and shifting (visually-guided with representational updating component) conditions while immersed in a 3D virtual reality environment. Greater end-point mediolateral errors to left-sided targets (remembered and shifting conditions) and overall lengthier onsets in reorientation strategy (shifting condition) were found for USN+ vs. USN- and vs. HC (p < 0.05). USN+ individuals mostly overshot left targets (− 15°/− 30°). Greater delays in detection time for target locations across the visual spectrum (left, middle and right) were found in USN+ vs. USN- and HC groups (p < 0.05). USN-related attentional-perceptual deficits alter navigation abilities in memory-guided and shifting conditions, independently of post-stroke locomotor deficits. Lateralized and non-lateralized deficits in object detection are found. The employed paradigm could be considered in the design and development of sensitive and functional assessment methods for neglect; thereby addressing the drawbacks of currently used traditional paper-and-pencil tools.
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ecological virtual reality evaluation of neglect symptoms evens effects of virtual scene complexity in the assessment of poststroke Unilateral Spatial neglect
Neurorehabilitation and Neural Repair, 2018Co-Authors: Tatiana Ogourtsova, Philippe Archambault, Anouk Lamontagne, Samir SanganiAbstract:Background. Unilateral Spatial neglect (USN) is a highly prevalent and disabling poststroke impairment. USN is traditionally assessed with paper-and-pencil tests that lack ecological validity, generalization to real-life situations and are easily compensated for in chronic stages. Virtual reality (VR) can, however, counteract these limitations. Objective. We aimed to examine the feasibility of a novel assessment of USN symptoms in a functional shopping activity, the Ecological VR-based Evaluation of Neglect Symptoms (EVENS). Methods. EVENS is immersive and consists of simple and complex 3-dimensional scenes depicting grocery shopping shelves, where joystick-based object detection and navigation tasks are performed while seated. Effects of virtual scene complexity on navigational and detection abilities in patients with (USN+, n = 12) and without (USN−, n = 15) USN following a right hemisphere stroke and in age-matched healthy controls (HC, n = 9) were determined. Results. Longer detection times, larger me...
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let s do groceries a novel virtual assessment for post stroke Unilateral Spatial neglect
International Conference on Virtual Rehabilitation, 2017Co-Authors: Tatiana Ogourtsova, Philippe S Archambault, Anouk LamontagneAbstract:Background: Unilateral Spatial neglect (USN), a highly prevalent post-stroke impairment, has been strongly associated with poor functional outcomes in self-care and instrumental activities of daily living. Hence, its sensitive detection is crucial. Yet, conventional USN assessments present with significant limitations, often leading to misdiagnosis. Virtual reality (VR) can be used to counteract those issues and increase detection sensitivity. Objective: To examine the feasibility, refine development and promote future implementation of a novel Ecological VR-based Evaluation of Neglect Symptoms (EVENS). Methods: EVENS consists of two (simple and complex) immersive, 3-D scenes, depicting grocery shopping shelves, where object-detection and navigation tasks are performed using a joystick. Through a cross-sectional study, the effects of virtual scene complexity on navigational and detection abilities in patients with (USN+) and without (USN−) post-stroke USN and in healthy controls (HC) were determined. These findings were complimented by gathering the opinion of clinicians and experts in the field as to the barriers/facilitators to the use of VR and the features for an optimal assessment. Results: Longer detection times and larger mediolateral deviations from ideal paths were found in USN+ vs. USN− and HC groups. Several barriers/facilitators for clinical VR use and features of an optimal VR-based tool were identified. Conclusion: Navigation and detection abilities are affected by environmental complexity of the VR scene in individuals with post-stroke USN and can be employed for USN assessment. The present knowledge translation initiatives can refine EVENS' design and promote its future application and adherence to its use in clinical settings.
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virtual reality treatment and assessments for post stroke Unilateral Spatial neglect a systematic literature review
Neuropsychological Rehabilitation, 2017Co-Authors: Tatiana Ogourtsova, Philippe Archambault, Anouk Lamontagne, Wagner Souza SilvaAbstract:Unilateral Spatial neglect (USN) is a highly prevalent post-stroke deficit. Currently, there is no gold standard USN assessment which encompasses the heterogeneity of this disorder and that is sensitive to detect mild deficits. Similarly, there is a limited number of high quality studies suggesting that conventional USN treatments are effective in improving functional outcomes and reducing disability. Virtual reality (VR) provides enhanced methods for USN assessment and treatment. To establish best-practice recommendations with respect to its use, it is necessary to appraise the existing evidence. This systematic review aimed to identify and appraise existing VR-based USN assessments; and to determine whether VR is more effective than conventional therapy. Assessment tools were critically appraised using standard criteria. The methodological quality of the treatment trials was rated by two authors. The level of evidence according to stage of recovery was determined. Findings were compiled into a VR-based USN Assessment and Treatment Toolkit (VR-ATT). Twenty-three studies were identified. The proposed VR tools augmented the conventional assessment strategies. However, most studies lacked analysis of psychometric properties. There is limited evidence that VR is more effective than conventional therapy in improving USN symptoms in patients with stroke. It was concluded that VR-ATT could facilitate identification and decision-making as to the appropriateness of VR-based USN assessments and treatments across the continuum of stroke care, but more evidence is required on treatment effectiveness.
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impact of post stroke Unilateral Spatial neglect on goal directed arm movements systematic literature review
Topics in Stroke Rehabilitation, 2015Co-Authors: Tatiana Ogourtsova, Philippe Archambault, Anouk LamontagneAbstract:Background: Unilateral Spatial neglect (USN), a highly prevalent post-stroke impairment, refers to one's inability to orient or respond to stimuli located in the contralesional visual hemispace. Unilateral Spatial neglect has been shown to strongly affect motor performance in functional activities, including non-affected upper extremity (UE) movements. To date, our understanding of the effects of USN on goal-directed UE movements is limited and comparing performance of individuals post-stroke with and without USN is required.Objective: To determine, in individuals with stroke, how does the presence of USN, in comparison to the absence of USN, impacts different types of goal-directed movements of the non-affected UE.Methods: The present review approach consisted of a comprehensive literature search, an assessment of the quality of the selected studies and qualitative data analysis.Results: A total of 20 studies of moderate to high quality were selected. The USN-specific impairments were found in tasks that...
Meigen Liu - One of the best experts on this subject based on the ideXlab platform.
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influence of right versus left Unilateral Spatial neglect on the functional recovery after rehabilitation in sub acute stroke patients
Neuropsychological Rehabilitation, 2020Co-Authors: Tomomi Yoshida, Katsuhiro Mizuno, Anna Miyamoto, Kunitsugu Kondo, Meigen LiuAbstract:Unilateral Spatial neglect (USN) may lead to poor functional rehabilitation outcomes. However, studies investigating the rehabilitation outcomes of right-sided USN are lacking. We aimed to investig...
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influence of right versus left Unilateral Spatial neglect on the functional recovery after rehabilitation in sub acute stroke patients
Neuropsychological Rehabilitation, 2020Co-Authors: Tomomi Yoshida, Katsuhiro Mizuno, Anna Miyamoto, Kunitsugu Kondo, Meigen LiuAbstract:Unilateral Spatial neglect (USN) may lead to poor functional rehabilitation outcomes. However, studies investigating the rehabilitation outcomes of right-sided USN are lacking. We aimed to investigate (1) the clinical impacts of USN, including right-sided USN, for stroke patients in sub-acute rehabilitation, and (2) evaluate the differences in clinical characteristics and rehabilitation outcomes between right- and left-sided USN patients. We retrospectively screened the medical records of 297 inpatients at the Tokyo-Bay Rehabilitation Hospital who experienced a cerebrovascular accident with supratentorial lesions between January 1st, 2014 and December 31st, 2016. We performed independent multiple regression analysis in patients with left and right hemisphere damage. The Behavioral Inattention Test was a significant independent variable for predicting the motor, cognitive, and total functional independence measure (FIM), compared to the Stroke Impairment Assessment Set and Mini-Mental State Examination. USN affects motor FIM recovery more than cognitive FIM recovery regardless of the damaged hemisphere. Our study results confirm that both right- and left-sided USN influence the functional recovery of stroke patients. USN occurs, slightly less frequently, following a left hemisphere stroke. However, USN negatively affected rehabilitation outcomes, regardless of the neglected side. Therefore, USN treatment is necessary for patients with left and right hemisphere damage.
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right as well as left Unilateral Spatial neglect influences rehabilitation outcomes and its recovery is important for determining discharge destination in subacute stroke patients
European Journal of Physical and Rehabilitation Medicine, 2020Co-Authors: Kengo Tsujimoto, Katsuhiro Mizuno, Yukiko Kobayashi, Akira Tanuma, Meigen LiuAbstract:BACKGROUND Unilateral Spatial neglect (USN) can interfere with rehabilitation processes and lead to poor functional outcome. AIM To investigate the influence of left and right USN on rehabilitation outcomes using Catherine Bergego Scale (CBS) in stroke patients and the relationships among improvement of USN, improvement of motor autonomy (measured by functional independence measure [FIM] gain), length of stay and discharge destination. DESIGN Observational study. SETTING Rehabilitation hospital in Japan. POPULATION We investigated 60 first-ever stroke patients who were admitted to a rehabilitation hospital within 3 months after stroke onset (27 patients with neglect and 33 without neglect). METHODS Multiple regression analyses were used to explain FIM gain, FIM effectiveness and length of stay. Independent variables were motor and cognitive FIM, CBS, Stroke Impairment Assessment Set Motor Score (SIAS-M) and time after stroke onset at admission. RESULTS The incidences of USN in patients with right and left hemisphere damage were 55.6% and 37.1%, respectively. CBS predicted motor FIM, motor FIM gain, motor FIM effectiveness and length of stay. On the other hand, SIAS-M did not predict either FIM nor length of stay. CBS Score decreased significantly in patients with USN who retuned their home, while it did not change in patients who did not. Cognitive FIM Score at admission was significantly lower in patients who did not return home than in patients who returned home. CONCLUSIONS CBS is more useful than SIAS-M for prediction of functional outcomes in patients with both left and right hemisphere damages. Improvement of USN is important for returning home. Cognitive impairment may interfere with recovery of USN. CLINICAL REHABILITATION IMPACT Improvements of USN are important for planning the rehabilitation goal and determination of discharge destination.
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early visual processing is affected by clinical subtype in patients with Unilateral Spatial neglect a magnetoencephalography study
Frontiers in Human Neuroscience, 2013Co-Authors: Yves Rossetti, Katsuhiro Mizuno, Tetsuya Tsuji, Hisao Ohde, Meigen LiuAbstract:OBJECTIVE: To determine whether visual evoked fields (VEFs) elicited by right and left hemifield stimulation differ in patients with Unilateral Spatial neglect that results from cerebrovascular accident. METHODS: Pattern-reversal stimulation of the right and left hemifield was performed in three patients with left Unilateral Spatial neglect. Magnetoencephalography was recorded using a 160-channel system, and VEFs were quantified in the 400 ms after each stimulus. The presence or absence of VEF components at around 100 ms (P100m component) and 145 ms (N145m component) after stimulus onset was determined. The source of the VEF was determined using a single equivalent current dipole model for spherical volume conduction. All patients were evaluated using the behavioral inattention test (BIT). RESULTS: In response to right hemifield stimulation, the P100m and N145m components of the VEF were evident in all three patients. In response to left hemifield stimulation, both components were evident in Patient 3, whereas only the P100m component was evident in Patient 1 and only the N145m component was evident in Patient 2. Patient 1 exhibited impairments on the line bisection and cancellation tasks of the BIT, Patient 2 exhibited impairments on the copying, drawing and cancellation tasks of the BIT, and Patient 3 exhibited impairments on the cancellation task of the BIT. CONCLUSIONS: These results demonstrate that early VEFs are disrupted in patients with Unilateral Spatial neglect and support the concept that deficits in visual processing differ according to the clinical subtype of Unilateral Spatial neglect and the lesion location. This study also demonstrates the feasibility of using magnetoencephalography to explore subtypes of neglect.
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prism adaptation therapy enhances rehabilitation of stroke patients with Unilateral Spatial neglect a randomized controlled trial
Neurorehabilitation and Neural Repair, 2011Co-Authors: Katsuhiro Mizuno, Tetsuya Tsuji, Toru Takebayashi, Toshiyuki Fujiwara, Kimitaka Hase, Meigen LiuAbstract:Background and objective. Unilateral Spatial neglect (USN) can interfere with rehabilitation processes and lead to poor functional outcome. The purpose of this study was to determine whether prism adaptation (PA) therapy improves USN and functional outcomes in stroke patients in the subacute stage. Methods. A multicenter, double-masked, randomized, controlled trial was conducted to evaluate the effects of a 2-week PA therapy on USN assessed with the Behavioral Inattention Test (BIT), the Catherine Bergego Scale (CBS), and activities of daily living (ADL) as evaluated with the Functional Independence Measure (FIM). A total of 38 USN patients with right-brain damage were divided into prism (n = 20) and control (n = 18) groups. Patients were divided into mild and severe USN groups according to BIT behavioral test (mild ≥ 55 and severe<55). The prism group performed repetitive pointing with prism glasses that induce rightward optical shift twice daily, 5 days per week, for 2 weeks, whereas the control group p...
Nicol Kornerbitensky - One of the best experts on this subject based on the ideXlab platform.
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determining the barriers and facilitators to adopting best practices in the management of poststroke Unilateral Spatial neglect results of a qualitative study
Topics in Stroke Rehabilitation, 2014Co-Authors: Anita Petzold, Nicol Kornerbitensky, Nancy M Salbach, Sara Ahmed, Anita Menon, Tatiana OgourtsovaAbstract:AbstractBackground: A gap exists between best and actual management of poststroke Unilateral Spatial neglect (USN). Given the negative impact of USN on poststroke recovery, knowledge translation efforts are needed to optimize USN management. To date, no study has investigated the specific barriers and facilitators affecting USN management during the acute care process. Objective: To identify the facilitators and barriers that affect evidence-based practice use by occupational therapists (the primary discipline managing USN) when treating individuals with acute poststroke USN. Methods: Focus group methodology elicited information from 9 acute care occupational therapists. Results: Key barriers identified included lack of basic evidence-based practice skills specific to USN treatment and personal motivation to change current practices and engrained habits. Key facilitators included the presence of a multidisciplinary stroke team, recent graduation, and an environment with access to learning time and resourc...
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increasing knowledge of best practices for occupational therapists treating post stroke Unilateral Spatial neglect results of a knowledge translation intervention study
Journal of Rehabilitation Medicine, 2012Co-Authors: Anita Petzold, Nicol Kornerbitensky, Nancy M Salbach, Sara Ahmed, Anita Menon, Tatiana OgourtsovaAbstract:Objective: The aim of this study was to investigate: (i) the feasibility of delivering a multi-modal knowledge translation intervention specific to the management of acute post-stroke Unilateral Spatial neglect; and (ii) the impact of the knowledge translation intervention on occupational therapists' knowledge of evidence-based Unilateral Spatial neglect problem identification, assessment and treatment, and self-efficacy related to evidence-based practice implementation. Design: A 3-period (pre-post) repeated measures design. Subjects: Acute care occupational therapists treating patients with post-stroke Unilateral Spatial neglect were recruited from two major Canadian cities. Methods: Participants completed two pre-intervention assessments, took part in a day-long interactive multi-modal knowledge translation intervention and a subsequent 8-week follow-up, and completed a post-intervention assessment. Knowledge of evidence-based problem identification, assessment and treatment of Unilateral Spatial neglect, and self-efficacy to perform evidence-based practice activities were measured using standard scales. Results: The intervention was tested on 20 occupational therapists. Results indicate a significant improvement in knowledge of best practice Unilateral Spatial neglect management (p < 0.000) and evidence-based practice self-efficacy in carrying out evidence-based practice activities (p < 0.045) post-intervention. Conclusion: Use of a multi-modal knowledge translation intervention is feasible and can significantly improve occupational therapists' knowledge of Unilateral Spatial neglect best practices and self-efficacy. The findings should help advance best practices specific to the management of post-stroke Unilateral Spatial neglect as well as informing knowledge translation studies in other areas of practice.
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contribution of the superior colliculi to post stroke Unilateral Spatial neglect and recovery
Neuropsychologia, 2010Co-Authors: Tatiana Ogourtsova, Nicol Kornerbitensky, Alain PtitoAbstract:Unilateral Spatial neglect (USN) is a highly prevalent and disabling consequence of stroke that often responds poorly to existing interventions. Its underlying neural mechanisms are still unclear. Recent work suggests that post-stroke USN may be partly related to a disruption of top-down and bottom-up control of visual attention mediated in part through the midbrain superior colliculi (SC). With mounting evidence from animal and human research, our objectives were: (1) to synthesize the literature implicating the SC in USN; (2) to review the rationale and potential for using eye patching and prism adaptation as USN treatment approaches that recruit SC involvement; and (3) to provide recommendations for research on the potential of therapeutic interventions that involve and/or target the retino-collicular pathway. Given the paucity of human studies, the contribution of the SC in USN, while plausible, remains to be confirmed. Further exploration of the mechanisms involved and their impact on USN in human subjects will help develop theoretically based intervention strategies tailored to USN type.
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occupational therapists identification assessment and treatment of Unilateral Spatial neglect during stroke rehabilitation in canada
Stroke, 2007Co-Authors: Anita Menonnair, Nicol Kornerbitensky, Tatiana OgourtsovaAbstract:Background and Purpose— Unilateral Spatial neglect (USN) is a disabling feature of stroke, and its identification and management are critical for optimizing patient outcomes. This study examined USN problem identification, assessment, and treatment among clinicians working in stroke rehabilitation. Methods— This report was based on a Canada-wide survey of 253 occupational therapists providing inpatient stroke rehabilitation. Results— Eighty percent (n=202) recognized USN as a potential problem, 27% (n=67) reported using standardized USN assessment tools, and 58% (n=147) indicated using USN interventions. Working on a stroke unit and younger age were among the variables explaining 7% to 19% of the variability in USN problem identification, assessment, and intervention use. Conclusions— Although USN problem identification was high, clinicians were unlikely to use standardized assessment tools or evidence-based interventions to effectively manage this serious impairment.
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assessment of Unilateral Spatial neglect post stroke in canadian acute care hospitals are we neglecting neglect
Clinical Rehabilitation, 2006Co-Authors: Anita Menonnair, Nicol Kornerbitensky, Sharon Wooddauphinee, Elizabeth RobertsonAbstract:Objective: To estimate the prevalence, timing and frequency of use of standardized and non-standardized assessments to detect Unilateral Spatial neglect in acute care patients post stroke.Design and setting: Multicentred, retrospective study on medical charts from 10 randomly selected acute care hospitals in Ontario, Canada.Subjects: Three hundred and twenty-four randomly selected medical charts of adult subjects with a primary diagnosis of stroke admitted in 2002 to the participating acute care hospitals.Results: Out of 248 subjects who should have been assessed, 38% received some form of Unilateral Spatial neglect assessment. Only 13% were assessed with a standardized assessment and of these, 4% within 48 h post stroke or within 48 h of the patient regaining consciousness as recommended by clinical practice guidelines for stroke. Bivariate analysis found significant associations between severity of cognitive impairment and being ever assessed, as well as between the severity of motor deficits of the upp...
Philippe Archambault - One of the best experts on this subject based on the ideXlab platform.
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post stroke Unilateral Spatial neglect virtual reality based navigation and detection tasks reveal lateralized and non lateralized deficits in tasks of varying perceptual and cognitive demands
Journal of Neuroengineering and Rehabilitation, 2018Co-Authors: Tatiana Ogourtsova, Philippe Archambault, Anouk LamontagneAbstract:Unilateral Spatial neglect (USN), a highly prevalent and disabling post-stroke impairment, has been shown to affect the recovery of locomotor and navigation skills needed for community mobility. We recently found that USN alters goal-directed locomotion in conditions of different cognitive/perceptual demands. However, sensorimotor post-stroke dysfunction (e.g. decreased walking speed) could have influenced the results. Analogous to a previously used goal-directed locomotor paradigm, a seated, joystick-driven navigation experiment, minimizing locomotor demands, was employed in individuals with and without post-stroke USN (USN+ and USN-, respectively) and healthy controls (HC). Participants (n = 15 per group) performed a seated, joystick-driven navigation and detection time task to targets 7 m away at 0°, ±15°/30° in actual (visually-guided), remembered (memory-guided) and shifting (visually-guided with representational updating component) conditions while immersed in a 3D virtual reality environment. Greater end-point mediolateral errors to left-sided targets (remembered and shifting conditions) and overall lengthier onsets in reorientation strategy (shifting condition) were found for USN+ vs. USN- and vs. HC (p < 0.05). USN+ individuals mostly overshot left targets (− 15°/− 30°). Greater delays in detection time for target locations across the visual spectrum (left, middle and right) were found in USN+ vs. USN- and HC groups (p < 0.05). USN-related attentional-perceptual deficits alter navigation abilities in memory-guided and shifting conditions, independently of post-stroke locomotor deficits. Lateralized and non-lateralized deficits in object detection are found. The employed paradigm could be considered in the design and development of sensitive and functional assessment methods for neglect; thereby addressing the drawbacks of currently used traditional paper-and-pencil tools.
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ecological virtual reality evaluation of neglect symptoms evens effects of virtual scene complexity in the assessment of poststroke Unilateral Spatial neglect
Neurorehabilitation and Neural Repair, 2018Co-Authors: Tatiana Ogourtsova, Philippe Archambault, Anouk Lamontagne, Samir SanganiAbstract:Background. Unilateral Spatial neglect (USN) is a highly prevalent and disabling poststroke impairment. USN is traditionally assessed with paper-and-pencil tests that lack ecological validity, generalization to real-life situations and are easily compensated for in chronic stages. Virtual reality (VR) can, however, counteract these limitations. Objective. We aimed to examine the feasibility of a novel assessment of USN symptoms in a functional shopping activity, the Ecological VR-based Evaluation of Neglect Symptoms (EVENS). Methods. EVENS is immersive and consists of simple and complex 3-dimensional scenes depicting grocery shopping shelves, where joystick-based object detection and navigation tasks are performed while seated. Effects of virtual scene complexity on navigational and detection abilities in patients with (USN+, n = 12) and without (USN−, n = 15) USN following a right hemisphere stroke and in age-matched healthy controls (HC, n = 9) were determined. Results. Longer detection times, larger me...
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virtual reality treatment and assessments for post stroke Unilateral Spatial neglect a systematic literature review
Neuropsychological Rehabilitation, 2017Co-Authors: Tatiana Ogourtsova, Philippe Archambault, Anouk Lamontagne, Wagner Souza SilvaAbstract:Unilateral Spatial neglect (USN) is a highly prevalent post-stroke deficit. Currently, there is no gold standard USN assessment which encompasses the heterogeneity of this disorder and that is sensitive to detect mild deficits. Similarly, there is a limited number of high quality studies suggesting that conventional USN treatments are effective in improving functional outcomes and reducing disability. Virtual reality (VR) provides enhanced methods for USN assessment and treatment. To establish best-practice recommendations with respect to its use, it is necessary to appraise the existing evidence. This systematic review aimed to identify and appraise existing VR-based USN assessments; and to determine whether VR is more effective than conventional therapy. Assessment tools were critically appraised using standard criteria. The methodological quality of the treatment trials was rated by two authors. The level of evidence according to stage of recovery was determined. Findings were compiled into a VR-based USN Assessment and Treatment Toolkit (VR-ATT). Twenty-three studies were identified. The proposed VR tools augmented the conventional assessment strategies. However, most studies lacked analysis of psychometric properties. There is limited evidence that VR is more effective than conventional therapy in improving USN symptoms in patients with stroke. It was concluded that VR-ATT could facilitate identification and decision-making as to the appropriateness of VR-based USN assessments and treatments across the continuum of stroke care, but more evidence is required on treatment effectiveness.
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impact of post stroke Unilateral Spatial neglect on goal directed arm movements systematic literature review
Topics in Stroke Rehabilitation, 2015Co-Authors: Tatiana Ogourtsova, Philippe Archambault, Anouk LamontagneAbstract:Background: Unilateral Spatial neglect (USN), a highly prevalent post-stroke impairment, refers to one's inability to orient or respond to stimuli located in the contralesional visual hemispace. Unilateral Spatial neglect has been shown to strongly affect motor performance in functional activities, including non-affected upper extremity (UE) movements. To date, our understanding of the effects of USN on goal-directed UE movements is limited and comparing performance of individuals post-stroke with and without USN is required.Objective: To determine, in individuals with stroke, how does the presence of USN, in comparison to the absence of USN, impacts different types of goal-directed movements of the non-affected UE.Methods: The present review approach consisted of a comprehensive literature search, an assessment of the quality of the selected studies and qualitative data analysis.Results: A total of 20 studies of moderate to high quality were selected. The USN-specific impairments were found in tasks that...
