Cargando…

Midline Body Actions and Leftward Spatial “Aiming” in Patients with Spatial Neglect

Spatial motor–intentional “Aiming” bias is a dysfunction in initiation/execution of motor–intentional behavior, resulting in hypokinetic and hypometric leftward movements. Aiming bias may contribute to posture, balance, and movement problems and uniquely account for disability in post-stroke spatial...

Descripción completa

Detalles Bibliográficos
Autores principales: Chaudhari, Amit, Pigott, Kara, Barrett, A. M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498387/
https://www.ncbi.nlm.nih.gov/pubmed/26217211
http://dx.doi.org/10.3389/fnhum.2015.00393
_version_ 1782380621076627456
author Chaudhari, Amit
Pigott, Kara
Barrett, A. M.
author_facet Chaudhari, Amit
Pigott, Kara
Barrett, A. M.
author_sort Chaudhari, Amit
collection PubMed
description Spatial motor–intentional “Aiming” bias is a dysfunction in initiation/execution of motor–intentional behavior, resulting in hypokinetic and hypometric leftward movements. Aiming bias may contribute to posture, balance, and movement problems and uniquely account for disability in post-stroke spatial neglect. Body movement may modify and even worsen Aiming errors, but therapy techniques, such as visual scanning training, do not take this into account. Here, we evaluated (1) whether instructing neglect patients to move midline body parts improves their ability to explore left space and (2) whether this has a different impact on different patients. A 68-year-old woman with spatial neglect after a right basal ganglia infarct had difficulty orienting to and identifying left-sided objects. She was prompted with four instructions: “look to the left,” “point with your nose to the left,” “point with your [right] hand to the left,” and “stick out your tongue and point it to the left.” She oriented leftward dramatically better when pointing with the tongue/nose, than she did when pointing with the hand. We then tested nine more consecutive patients with spatial neglect using the same instructions. Only four of them made any orienting errors. Only one patient made >50% errors when pointing with the hand, and she did not benefit from pointing with the tongue/nose. We observed that pointing with the tongue could facilitate left-sided orientation in a stroke survivor with spatial neglect. If midline structures are represented more bilaterally, they may be less affected by Aiming bias. Alternatively, moving the body midline may be more permissive for leftward orienting than moving right body parts. We were not able to replicate this effect in another patient; we suspect that the magnitude of this effect may depend upon the degree to which patients have directional akinesia, spatial Where deficits, or cerebellar/frontal cortical lesions. Future research could examine these hypotheses.
format Online
Article
Text
id pubmed-4498387
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-44983872015-07-27 Midline Body Actions and Leftward Spatial “Aiming” in Patients with Spatial Neglect Chaudhari, Amit Pigott, Kara Barrett, A. M. Front Hum Neurosci Neuroscience Spatial motor–intentional “Aiming” bias is a dysfunction in initiation/execution of motor–intentional behavior, resulting in hypokinetic and hypometric leftward movements. Aiming bias may contribute to posture, balance, and movement problems and uniquely account for disability in post-stroke spatial neglect. Body movement may modify and even worsen Aiming errors, but therapy techniques, such as visual scanning training, do not take this into account. Here, we evaluated (1) whether instructing neglect patients to move midline body parts improves their ability to explore left space and (2) whether this has a different impact on different patients. A 68-year-old woman with spatial neglect after a right basal ganglia infarct had difficulty orienting to and identifying left-sided objects. She was prompted with four instructions: “look to the left,” “point with your nose to the left,” “point with your [right] hand to the left,” and “stick out your tongue and point it to the left.” She oriented leftward dramatically better when pointing with the tongue/nose, than she did when pointing with the hand. We then tested nine more consecutive patients with spatial neglect using the same instructions. Only four of them made any orienting errors. Only one patient made >50% errors when pointing with the hand, and she did not benefit from pointing with the tongue/nose. We observed that pointing with the tongue could facilitate left-sided orientation in a stroke survivor with spatial neglect. If midline structures are represented more bilaterally, they may be less affected by Aiming bias. Alternatively, moving the body midline may be more permissive for leftward orienting than moving right body parts. We were not able to replicate this effect in another patient; we suspect that the magnitude of this effect may depend upon the degree to which patients have directional akinesia, spatial Where deficits, or cerebellar/frontal cortical lesions. Future research could examine these hypotheses. Frontiers Media S.A. 2015-07-10 /pmc/articles/PMC4498387/ /pubmed/26217211 http://dx.doi.org/10.3389/fnhum.2015.00393 Text en Copyright © 2015 Chaudhari, Pigott and Barrett. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Chaudhari, Amit
Pigott, Kara
Barrett, A. M.
Midline Body Actions and Leftward Spatial “Aiming” in Patients with Spatial Neglect
title Midline Body Actions and Leftward Spatial “Aiming” in Patients with Spatial Neglect
title_full Midline Body Actions and Leftward Spatial “Aiming” in Patients with Spatial Neglect
title_fullStr Midline Body Actions and Leftward Spatial “Aiming” in Patients with Spatial Neglect
title_full_unstemmed Midline Body Actions and Leftward Spatial “Aiming” in Patients with Spatial Neglect
title_short Midline Body Actions and Leftward Spatial “Aiming” in Patients with Spatial Neglect
title_sort midline body actions and leftward spatial “aiming” in patients with spatial neglect
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498387/
https://www.ncbi.nlm.nih.gov/pubmed/26217211
http://dx.doi.org/10.3389/fnhum.2015.00393
work_keys_str_mv AT chaudhariamit midlinebodyactionsandleftwardspatialaiminginpatientswithspatialneglect
AT pigottkara midlinebodyactionsandleftwardspatialaiminginpatientswithspatialneglect
AT barrettam midlinebodyactionsandleftwardspatialaiminginpatientswithspatialneglect