Right Cerebrovascular Accident Research Articles

CEREBRAL LATERALITY, EMOTION, AND CARDIOPULMONARY FUNCTIONS: AN INVESTIGATION OF LEFT AND RIGHT CVA PATIENTS

Background: It has been evidenced that the outcome of a CVA patient differs as a function of the cerebral hemisphere that is damaged by the stroke, especially in terms of emotional changes. In contrast, the Bi-Hemispheric Model of Emotion posits that each hemisphere has its own emotional specialization. The current experiment tested the competing predictions of the two theoretical perspectives in a mixed sample of left cerebrovascular accident (LCVA) patients and right cerebrovascular accident (RCVA) patients using a Dichotic Listening task and the Affective Auditory Verbal Learning Test (AAVLT). Heart Rate (HR) and Pulse Oxygen Saturation (SpO2) were recorded as sympathetic measures. It was expected that the predictions of the Bi-Hemispheric Model would be supported. A series of mixed design ANOVAs were used to analyze the data. Material/Methods: Participants consisted of 21 patients grouped into either post-acute status left cerebrovascular accident (LCVA) or right cerebrovascular accident (RCVA). Tests included the The Dichotic Listening test, The Affective Auditory Verbal Learning Test (AAVLT), HR and Sp02 measurement using a Fingertip Pulse Oximeter and the Mood Assessment Scale for depression. Results: Results revealed that both groups exhibited decreased auditory detection abilities in the ear contralateral to CVA location. Additionally, CVA patients recalled significantly more positive words than negative or neutral words and exhibited a significant learning curve. LCVA patients exhibited a recency effect, while RCVA patients exhibited a heigh tened primacy effect. Findings from the HR and Sp02 measures suggested a parasympathetic response to emotionally neutral information as well as an impaired sympathetic response to emotionally negative information in RCVA patients. Conclusions: The results lend partial support to the hypothesis drawn from the Bi-Hemispheric Model of Emotion, as evidenced by the diametrically opposite effects in these groups, which reflects opposing cerebral processes.

Telerehabilitation and its effect on story retelling by adults with neurogenic communication disorders

Background: Telerehabilitation (telerehab) is the method of using technology to provide rehabilitation services at a distance. The concept of delivering remote speech‐language pathology (SLP) services using telerehab tools and techniques has been acknowledged for more than 25 years. While research has demonstrated videoconference‐based telerehab to be a feasible, effective, and appropriate method for providing SLP services to a broad range of clients, studies have been primarily limited to technical feasibility or demonstration projects with relatively small sample sizes. There is an expressed need in the literature for controlled, randomised studies that track both quantitative outcomes of services delivered via telerehab as well as qualitative measures of satisfaction.Aims: The purpose of the study was to measure performance of adults with acquired brain injury on a standardised SLP assessment conducted in both face‐to‐face (FF) and videoconference‐based telerehab (T) settings. The objective was to determine if performance on the assessment, or subjective feedback from the participants, differed between settings.Methods & Procedures: A total of 40 participants with a recent onset of brain injury—12 with traumatic brain injury (TBI), 14 with a left cerebrovascular accident (LCVA), and 14 with a right cerebrovascular accident (RCVA)—were enrolled in the study. Participants were asked to retell stories from the Story Retell Procedure (Doyle, McNeil, Spencer, Goda, Cotrell, & Lustig, 1998) in both FF and T settings. Responses from the stories were scored by the clinician using the percent information unit scoring metric (McNeil, Doyle, Fossett, Park, & Goda, 2001). Additionally, a survey tool was used to probe each participant's level of satisfaction and willingness to use telerehab services in the future.Outcomes & Results: Across all participants, and within the TBI, LCVA, and RCVA groups, no significant difference in performance between the FF and T settings was found. Feedback from survey data demonstrated a high level of acceptance of the T setting. When compared to participants with LCVA or RCVA, however, participants with TBI were significantly more likely to show a lack of interest in future videoconferencing use.Conclusions: Story‐retelling performance by brain‐injured adults was not affected by setting. Additionally, participants expressed a high level of interest in using videoconferencing in the future. These findings offer additional support for telerehab as a viable alternative mode of SLP treatment for survivors of stroke and TBI. Further research is needed to investigate the utility of telerehab for delivering services to clients with attention impairments as well as those with severe cognitive‐communicative impairment, dysarthria, or aphasia.

Impairments in arm control in subjects with left and right hemisphere stroke1

Our purpose was to identify impairments in movement control for subjects with left and right brain lesions using a kinematic analysis of the trajectory of a stylus during an upper limb tapping task. We hypothesized that subjects with left cerebrovascular accident (LCVA) would have bilateral deficits in programming while subjects with right cerebrovascular accident (RCVA) would only have deficits in the limb contralateral to the lesion. Data were collected from 11 subjects with LCVA, 11 with RCVA, and 22 non-disabled subjects who were age and gender-matched to subjects with left or RCVA. Subjects were videotaped performing a Fitts tapping task on a single 3-inch target with each hand. The stylus movement was digitized at 60 Hz and data were calculated for each tap cycle and averaged across each 10-s trial. We examined differences in the kinematic variables of cycle frequency, amplitude, symmetry in up and down velocity, symmetry in timing of up and down velocity, and temporal phases of acceleration and deceleration for up and down directions of the tap cycle. Multivariate analyses were performed on four dependent kinematic variables, and univariate ANOVAs were conducted for the differences in phases between stroke and non-disabled limbs. Subject with LCVA showed lower frequencies, and asymmetrical velocity and timing ratio in both 'uninvolved' and 'involved' limbs compared to non-disabled subjects. Subjects with RCVA showed similar impairments for the 'involved' limb only. Left hemisphere lesions create bilateral impairments in programming movement reversals. Right hemisphere lesions produced deficits only for the limb contralateral to the lesion. Strategies used by the subjects with LCVA may be-related to the need for subjects to use feedback to perform this rapid continuous sequencing task. Suggestions for rehabilitation are presented.

Impairments in arm control in subjects with left and right hemisphere stroke

OBJECTIVES Our purpose was to identify impairments in movement control for subjects with left and right brain lesions using a kinematic analysis of the trajectory of a stylus during an upper limb tapping task. We hypothesized that subjects with left cerebrovascular accident (LCVA) would have bilateral deficits in programming while subjects with right cerebrovascular accident (RCVA) would only have deficits in the limb contralateral to the lesion. STUDY DESIGN Data were collected from 11 subjects with LCVA, 11 with RCVA, and 22 non-disabled subjects who were age and gender-matched to subjects with left or RCVA. Subjects were videotaped performing a Fitts tapping task on a single 3-inch target with each hand. The stylus movement was digitized at 60 Hz and data were calculated for each tap cycle and averaged across each 10-s trial. We examined differences in the kinematic variables of cycle frequency, amplitude, symmetry in up and down velocity, symmetry in timing of up and down velocity, and temporal phases of acceleration and deceleration for up and down directions of the tap cycle. Multivariate analyses were performed on four dependent kinematic variables, and univariate ANOVAs were conducted for the differences in phases between stroke and non-disabled limbs. RESULTS Subject with LCVA showed lower frequencies, and asymmetrical velocity and timing ratio in both 'uninvolved' and 'involved' limbs compared to non-disabled subjects. Subjects with RCVA showed similar impairments for the 'involved' limb only. CONCLUSIONS Left hemisphere lesions create bilateral impairments in programming movement reversals. Right hemisphere lesions produced deficits only for the limb contralateral to the lesion. Strategies used by the subjects with LCVA may be-related to the need for subjects to use feedback to perform this rapid continuous sequencing task. Suggestions for rehabilitation are presented.

Rightward orienting bias, wheelchair maneuvering, and fall risk

Objective: To investigate whether rightward orienting bias, without neglect of left hemispace, increased accident risk. Design: Case-control study. Setting: Inpatient rehabilitation unit of department of government medical center. Patients: Successive right-cerebrovascular accident (CVA) admissions were reviewed over a 2-year period. Only patients with left hemisphere damage, recent abusive drinking, dementia, or inpatient stays of less than 3 weeks were excluded. Fifty-five right-CVA subjects were divided into three groups, based on starting point and omissions in left hemispace on the ReyOsterreith Complex Figure Drawing and Random Letter Cancellation test. Thirty-two patients were placed in the L-OMIT group (omitted stimuli in left hemispace), 11 patients were placed in the R-BIAS group (began tasks to the right without omissions), and 12 patients were placed in the Non-Neglect Stroke group (no evidence of unilateral neglect). Twenty male inpatients with no history of brain damage served as controls (Normal Control). Main Outcome Measures: Frequency of hospital falls and wheelchair obstacle course contacts. Results: Both the L-OMIT and the R-BIAS groups had more inpatient falls than the other groups F(3,71) = 6.11, p < .001. On the wheelchair obstacle course, the L-OMIT group made more left-sided wheelchair collisions than any other group. However, the R-BIAS group also made more errors than the Non-Neglect Stroke and the Normal Control groups, F(3,55) = 5.72, p < .01). Conclusions: Results suggest that rightward orienting bias has clinical significance, even without more serious symptoms of unilateral neglect.

Visual Perception and Praxis in Adults After Stroke

The purpose of this study was to examine the performance of persons with right cerebrovascular accident (RCVA) and persons with left cerebrovascular accident (LCVA) on a variety of measures of praxis and visual perception in order to examine the relative contributions of the left and right cerebral hemispheres to praxis and perception. Forty-five subjects, 15 with RCVA, 15 with LCVA, and 15 without CVA (control subjects), were tested on three tests of praxis-praxic production, gesture comprehension, and gesture discrimination-and selected tests of visual perception, including the Judgement of Line Orientation Test, the Motor Free Visual Perception Test, the Hooper Visual Organization Test, and the Line Bisection Test. Subjects in both groups with CVA performed more poorly on all of the tests than did control subjects. The group with LCVA performed most poorly on tests of gesture comprehension and praxis production, whereas the group with RCVA performed most poorly on tests of gesture discrimination and visual perception. These findings suggest that both the right and left cerebral hemispheres contribute to different aspects of praxis. Elements of visual perception may be related to gesture comprehension, gesture discrimination, and praxis production in adults who have had stroke. These findings have clinical implications regarding instructional style and perceptual and praxic training.

A comparison of performance on the Raven coloured progressive matrices in patients with closed head injury (CHI), left cerebrovascular accidents (LCVA), and right cerebrovascular accidents (RCVA)

A comparison of performance on the Raven coloured progressive matrices in patients with closed head injury (CHI), left cerebrovascular accidents (LCVA), and right cerebrovascular accidents (RCVA)

A comparison of performance on the Raven coloured progressive matrices in patients with closed head injury (CHI), left cerebrovascular accidents (LCVA), and right cerebrovascular accidents (RCVA) : Norman, M.A., Gale, S.D., & Bigler, E.D. Brigham Young University, Department of Psychology

A comparison of performance on the Raven coloured progressive matrices in patients with closed head injury (CHI), left cerebrovascular accidents (LCVA), and right cerebrovascular accidents (RCVA) : Norman, M.A., Gale, S.D., & Bigler, E.D. Brigham Young University, Department of Psychology

Assessment of musical processing in brain-damaged patients: Implications for laterality of music

Reception and production aspects of musical ability were assessed in two studies of left cerebro-vascular accident (LCVA) and right cerebro-vascular accident (RCVA) patients and controls. Musical tasks included perception of rhythm and pitch variations in familiar and unfamiliar tunes; and production of a well-known song, three original melodies, and imitation of rhythm patterns. The only "laterality of music" effect to emerge in the first study was impaired ability in LVCA patients to correctly perceive rhythmic changes. In the second study LCVAs were poorer than the other two groups in the singing of novel melodies, and both lesioned groups were poorer than controls in singing a familiar tune and in tapping rhythms. Premorbid musical ability was significantly related to performance over all groups combined. The RCVA group showed an inconsistent pattern of performance. The LCVA group was consistently more impaired over all tasks but apart from the aforementioned effects this was nonsignificant. It is argued that laterality effects for music processing cannot be reliably established.