Biomedical subjects

H Chris Dijkerman

Publications and source records attributed to H Chris Dijkerman.

8 recordsLinked to original sources

PubMed2006

Recovery of hand function through mental practice: a study protocol.

BACKGROUND: The study aims to assess the therapeutic benefits of motor imagery training in stroke patients with persistent motor weakness. There is evidence to suggest that mental rehearsal of movement can produce effects normally attributed to practising the actual movements. Imagining hand movements could stimulate the redistribution of brain activity, which accompanies recovery of hand function, thus resulting in a reduced motor deficit. METHODS/DESIGN: A multi-centre randomised controlled trial recruiting individuals between one and six months post-stroke (n = 135). Patients are assessed before and after a four-week evaluation period. In this trial, 45 patients daily mentally rehearse movements with their affected arm under close supervision. Their recovery is compared to 45 patients who perform closely supervised non-motor mental rehearsal, and 45 patients who are not engaged in a training program. Motor imagery training effectiveness is evaluated using outcome measures of motor function, psychological processes, and level of disability. DISCUSSION: The idea of enhancing motor recovery through the use of motor imagery rehabilitation techniques is important with potential implications for clinical practice. The techniques evaluated as part of this randomised controlled trial are informed by the current understanding in cognitive neuroscience and the trial is both of scientific and applied interest.

Hand↗

PubMed2006

Pointing to places and spaces in a patient with visual form agnosia.

Previous investigations of visuospatial abilities in the visual form agnosic patient D.F. suggest that her egocentric sensorimotor processing is intact while her 'allocentric' judgments of spatial position are impaired. The current investigation extends these previous observations by comparing D.F.'s performance at pointing to a set of spatially distributed stimuli, either directly or by 'pantomiming' the responses in an adjacent homologous workspace. The results showed accurate sensorimotor localization when D.F. pointed directly to single targets or to sequences of targets, presumably as she could use egocentric visual coding. In spite of making relatively spared spatial judgments about the arrays, however, D.F. performed quite poorly when copying them and on the pantomimed pointing task. In this latter task good performance presumably depends on an ability to represent both the categorical and coordinate properties of the array (as does copying them), and to translate these into the effector-based coordinates required for accurate action. D.F.'s pantomimed pointing was similar to her copies of target arrays, as in both tasks there was evidence of spared (although somewhat degraded) appreciation of the relative spatial positions of the stimuli. Remarkably, her accuracy in this allocentric task was not worsened by longer pointing sequences. It is possible that D.F.'s degraded performance reflects a relative (though not complete) preservation of categorical coding within the ventral stream, despite a loss of coordinate coding there.

Adult↗

PubMed2004

Visuomotor performance in a patient with visual agnosia due to an early lesion.

We tested a patient with visual agnosia who had suffered severe bilateral brain damage early in life, on a series of visuomotor tasks. The broad pattern of results confirms that S.B., like the extensively tested patient D.F., shows an impressive array of preserved skills, despite his severe perceptual problems. Also like D.F., S.B. shows certain subtle visuomotor difficulties that can be related to the idea that his partially intact occipito-parietal areas are unable to benefit from interactions with the apparently severely damaged occipito-temporal regions. Unlike D.F., however, he is able to make accurate discriminations of simple visual features, such as object width and orientation, albeit with very slow response times. We hypothesize that several factors such as the early onset of S.B.'s lesion and the long period since his brain lesion have allowed his brain to compensate to a degree what has been impossible in D.F., whose brain damage occurred in adulthood. This may include an element of 'rewiring' and self-monitoring of visuomotor processes that allow S.B. to achieve perceptual access to visual information processed in the dorsal stream: information that is normally only available for on-line visuomotor control.

Adult↗

PubMed2004

"Mind the gap": the size-distance dissociation in visual neglect is a cueing effect.

There is a growing body of evidence that the processes mediating the allocation of spatial attention within objects may be separable from those governing attentional distribution between objects. In the neglect literature, a related proposal has been made regarding the perception of (within-object) sizes and (between-object) distances. This proposal follows observations that, in size-matching and bisection tasks, neglect is more strongly expressed when patients are required to attend to the sizes of discrete objects than to the (unfilled) distances between objects. These findings are consistent with a partial dissociation between size and distance processing, but a simpler alternative must also be considered. Whilst a neglect patient may fail to explore the full extent of a solid stimulus, the estimation of an unfilled distance requires that both endpoints be inspected before the task can be attempted at all. The attentional cueing implicit in distance estimation tasks might thus account for their superior performance by neglect patients. We report two bisection studies that address this issue. The first confirmed, amongst patients with left visual neglect, a reliable reduction of rightward error for unfilled "gap" stimuli as compared with solid lines. The second study assessed the cause of this reduction, deconfounding the effects of stimulus type (lines vs. gaps) and attentional cueing, by applying an explicit cueing manipulation to line and gap bisection tasks. Under these matched cueing conditions, all patients performed similarly on line and gap bisection tasks, suggesting that the reduction of neglect typically observed for gap stimuli may be attributable entirely to cueing effects. We found no evidence that a spatial extent, once fully attended, is judged any differently according to whether it is filled or unfilled.

Adult↗

PubMed2004

A revised method for analysing neglect using the landmark task.

In order to better disentangle 'perceptual' and 'response' biases in neglect patients, Bisiach and his co-workers developed a new version of the 'landmark task'. In their version, subjects are required to choose which is the longer (first condition) or the shorter (second condition) of the two portions of a pre-bisected horizontal line. Two indices were proposed, for the purpose of measuring perceptual and response bias respectively. The perceptual bias index (PB) is the constant error across conditions, while the response bias index (RB) is the degree of response consistency between conditions. Although valuable in a clinical context, these indices are not mathematically independent of one another. Furthermore, they do not exploit all of the information available in a given set of landmark data, since the responses made at the different landmark locations are all averaged together. To overcome these problems, we propose two new indices that can be derived from the revised landmark task. Our perceptual bias index is the Point of Subjective Equality (PSE)--the mean landmark location that appears to be halfway along the line. The response bias index, M, is the mean probability of making a response that opposes the patient's subjective midpoint. PSE and M are mathematically independent of each other and use most of the landmark information. The method and its theoretical foundation are summarized, and illustrative data obtained from brain damaged patients and control subjects are presented. Finally, computational procedures are provided for both PSE and M.

Brain↗

PubMed2003

Ocular scanning and perceptual size distortion in hemispatial neglect: effects of prism adaptation and sequential stimulus presentation.

When asked to compare two lateralized shapes for horizontal size, neglect patients often indicate the left stimulus to be smaller. Gainotti and Tiacci (1971) hypothesized that this phenomenon might be related to a rightward bias in the patients' gaze. This study aimed to assess the relation between this size underestimation and oculomotor asymmetries. Eye movements were recorded while three neglect patients judged the horizontal extent of two rectangles. Two experimental manipulations were performed to increase the likelihood of symmetrical scanning of the stimulus display. The first manipulation entailed a sequential, rather than simultaneous presentation of the two rectangles. The second required adaptation to rightward displacing prisms, which is known to reduce many manifestations of neglect. All patients consistently underestimated the left rectangle, but the pattern of verbal responses and eye movements suggested different underlying causes. These include a distortion of space perception without ocular asymmetry, a failure to view the full leftward extent of the left stimulus, and a high-level response bias. Sequential presentation of the rectangles and prism adaptation reduced ocular asymmetries without affecting size underestimation. Overall, the results suggest that leftward size underestimation in neglect can arise for a number of different reasons. Incomplete leftward scanning may perhaps be sufficient to induce perceptual size distortion, but it is not a necessary prerequisite.

Adaptation, Physiological↗

PubMedDate not supplied

Visual and tactile length matching in spatial neglect.

Previous studies have shown that many patients with spatial neglect underestimate the horizontal extent of leftwardly located shapes (presented on screen or on paper) relative to rightwardly located shapes. This has been used to help explain their leftward biases in line bisection. In the present study we have tested patients with right hemisphere damage, either with or without neglect, on a comparable length matching task, but using 3-dimensional objects. The task was executed first visually without tactile contact, and second through touch without vision. In both sense modalities, we found that patients with neglect, but not those without, tended to underestimate leftward located objects relative to rightward located objects, differing significantly in this regard from healthy subjects. However these lateral biases were not as frequent or as pronounced as in previous studies using 2-D visual shapes. Despite the similar asymmetries in the two sense modalities, we found only a small correlation between them, and clear double dissociations were observed among our patients. We conclude that leftward length underestimation cannot be attributed to any one single cause. First it cannot be entirely due to impairments in the visual pathways, such as hemianopia and/or processing biases, since the disorder is also seen in the tactile modality. At the same time, however, length underestimation phenomena cannot be fully explained as a disruption of a supramodal central size processor, since they can occur in either vision or touch alone. Our data would fit best with a multiple-factor model in which some patients show leftward length underestimation for modality-specific reasons, while others do so due to a more high-level disruption of size judgements.

Aged↗

PubMedDate not supplied

Grasping what is graspable: evidence from visual form agnosia.

Patient DF has profound visual form agnosia. Despite this, she has no problem adjusting her finger-thumb grip aperture to the width of objects when reaching to grasp them. In a previous study, however, she was found to have great difficulty in scaling her grip aperture when attempting to grasp a transparent disc through two holes cut into it. This problem was attributed to a putative difference between the visual processing of size and distance in the brain, whereby DF retained the capacity for processing object size but not the separation between distinct elements such as holes. In the present study we have tested this idea more directly, and found no evidence to support such a distinction. Nonetheless, we replicated our earlier finding that DF is unable to produce normal prehension movements when attempting to grasp transparent stimuli by placing her digits into holes. We suggest that, whilst some simple objects offer themselves directly to the dorsal stream for grasping, an intact ventral stream is required to respond appropriately to more complex stimuli.

Adult↗