The right hemisphere is dominant in organization of visual search—A study in stroke patients

Brink, Antonia F. Ten; Biesbroek, J. Matthijs; Kuijf, Hugo J.; Stigchel, Stefan Van der; Oort, Quirien; Visser-Meily, Johanna M A; Nijboer, Tanja C.W.

doi:10.1016/j.bbr.2016.02.004

Cited by 30 publications

(23 citation statements)

References 54 publications

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“…Since a negative relation has been reported between USN and postural balance (Nijboer, Ten Brink, Van Der Stoep, & Visser-Meily, 2014;van Nes et al, 2009), and disturbances in balance are related to problems in daily-life functioning (Suzuki, Ohyama, Yamada, & Kanamori, 2002), the measure of postural balance was included in the current study. During the balance task, the average sitting position and postural sway of the patient were measured in two conditions: with eyes open and with eyes closed (Nijboer, Olthoff, Van der Stigchel, & Visser-Meily, 2014).…”

Section: Physical Functioning and Physical Independencementioning

confidence: 99%

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Differences between left- and right-sided neglect revisited: A large cohort study across multiple domains

Brink

Verwer

Biesbroek

et al. 2016

Journal of Clinical and Experimental Neuropsychology

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Left USN (15.82%) was more frequent than right USN (9.25%). Demographic and stroke characteristics were comparable between groups. The lateralized attentional deficit was most severe in left USN. USN in both peripersonal and extrapersonal space was more frequently left-sided in nature. Search efficiency was lower in left USN. Balance was poorer in right USN. No differences between left and right USN were found for cognitive ability, communication, motor strength, mobility, and self-care. Most patients with left USN had right-hemispheric lesions, whereas patients with right USN could have lesions in either the left or the right hemisphere. To conclude, left and right USN are both common after stroke. Although the lateralized attention deficit is worse in left than in right USN, consequences at the level of physical functioning and physical independence are largely comparable. From a clinical perspective, it is important to systematically screen for USN, both after right- and after left-hemisphere damage.

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Section: Physical Functioning and Physical Independencementioning

confidence: 99%

“…Both theories, however, have received limited empirical support from neuroimaging studies. The nonspatial functions of the ventral attention network, such as reorienting, target detection, visual search, and arousal, are strongly right-hemisphere dominant (Bartolomeo, Thiebaut de Schotten, & Chica, 2012;Ten Brink, Biesbroek, et al, 2016).…”

mentioning

confidence: 99%

Differences between left- and right-sided neglect revisited: A large cohort study across multiple domains

Brink

Verwer

Biesbroek

et al. 2016

Journal of Clinical and Experimental Neuropsychology

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“…Second, only right-hemisphere, first-ever stroke patients were included. A recent study by Ten Brink et al [ 40 ] indicated that although the core component of VSN—the lateralised attention deficit—was more severe in left-sided compared to right-sided VSN, there was large overlap in clinical outcomes and impact of VSN on for example motor impairment and independence during ADLs. Given the subset of VSN patients in the present study, it remains unknown whether current results are hemisphere related (i.e.…”

Section: Discussionmentioning

confidence: 99%

Impact of clinical severity of stroke on the severity and recovery of visuospatial neglect

et al. 2018

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Background and purposeThere is growing evidence that visuospatial neglect (VSN) is associated with lower functional performance in other modalities and is not restricted to the lesioned hemisphere alone, and may also affect the non-lesioned hemisphere in severe first-ever strokes. We aimed to investigate the longitudinal association between the severity of VSN, as reflected by the extent of ipsilesional and contralesional spatial attention deficit, and clinical severity of stroke.MethodsThis is a secondary data analysis with merged data from two prospective cohort studies. Resulting in 90 patients and 8 longitudinal measurements at 1, 2, 3, 4, 5, 8, 12, and 26 weeks post-stroke onset. A letter cancellation test (LCT) was used as the primary outcome measure to demonstrate presence and severity of VSN. The clinical severity of stroke was classified using the Bamford Classification.ResultsNo significant association between clinical severity and the number of ipsilesional, as well as contralesional, omissions on the LCT was observed. Recovery of VSN at the contralesional hemiplegic, as well as ipsilesional non-hemiplegic side, was only dependent on ‘time’ as a reflection of spontaneous neurobiological recovery post-stroke. The recovery of the ipsilesional extension of VSN was significantly slower for the total anterior circulation infarct (TACI) group compared to the non-TACI group.ConclusionsLarger strokes have a significant negative impact on recovery of visual attention at the non-hemiplegic side. No clinical determinants that regulate spontaneous time-dependent recovery of VSN were found. While early ‘stroke severity’ has been regarded as a strong predictor of functional outcome at a group level, other prognostic factors (demographic, stroke related) need to be determined.Clinical trial registrationEXPLICIT-stroke Trial: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1424Stroke Intensity Trial: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1665

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“…Stroke patients with neglect are more likely to also suffer from disorganised search, 40 41 and some have argued that this is a consequence of disturbed spatial attention. 42 Across four indices of search organisation, we found moderate statistical evidence that guanfacine did not result in any improvements.…”

Section: Discussionmentioning

confidence: 73%

Randomised, double-blind, placebo-controlled crossover study of single-dose guanfacine in unilateral neglect following stroke

Dalmaijer

Gorgoraptis

et al. 2018

J Neurol Neurosurg Psychiatry

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ObjectiveUnilateral neglect is a poststroke disorder that impacts negatively on functional outcome and lacks established, effective treatment. This multicomponent syndrome is characterised by a directional bias of attention away from contralesional space, together with impairments in several cognitive domains, including sustained attention and spatial working memory. This study aimed to test the effects of guanfacine, a noradrenergic alpha-2A agonist, on ameliorating aspects of neglect.MethodsThirteen right hemisphere stroke patients with leftward neglect were included in a randomised, double-blind, placebo-controlled proof-of-concept crossover study that examined the effects of a single dose of guanfacine. Patients were tested on a computerised, time-limited cancellation paradigm, as well as tasks that independently assessed sustained attention and spatial working memory.ResultsOn guanfacine, there was a statistically significant improvement in the total number of targets found on the cancellation task when compared with placebo (mean improvement of 5, out of a possible 64). However, there was no evidence of a change in neglect patients’ directional attention bias. Furthermore, Bayesian statistical analysis revealed reliable evidence against any effects of guanfacine on search organisation and performance on our sustained attention and spatial working memory tasks.ConclusionsGuanfacine improves search in neglect by boosting the number of targets found but had no effects on directional bias or search organisation, nor did it improve sustained attention or working memory on independent tasks. Further work is necessary to determine whether longer term treatment with guanfacine may be effective for some neglect patients and whether it affects functional outcome measures.Trial registration numberNCT00955253.

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The right hemisphere is dominant in organization of visual search—A study in stroke patients

Cited by 30 publications

References 54 publications

Differences between left- and right-sided neglect revisited: A large cohort study across multiple domains

Differences between left- and right-sided neglect revisited: A large cohort study across multiple domains

Impact of clinical severity of stroke on the severity and recovery of visuospatial neglect

Randomised, double-blind, placebo-controlled crossover study of single-dose guanfacine in unilateral neglect following stroke

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