Visual-spatial Deficits Research Articles

Axial Postural Abnormalities in Parkinsonism: Gaps in Predictors, Pathophysiology, and Management.

Axial Postural Abnormalities in Parkinsonism: Gaps in Predictors, Pathophysiology, and Management.

Visual-spatial processing impairment in the occipital-frontal connectivity network at early stages of Alzheimer's disease.

Alzheimer's disease (AD) is the leading cause of dementia worldwide, but its pathophysiological phenomena are not fully elucidated. Many neurophysiological markers have been suggested to identify early cognitive impairments of AD. However, the diagnosis of this disease remains a challenge for specialists. In the present cross-sectional study, our objective was to evaluate the manifestations and mechanisms underlying visual-spatial deficits at the early stages of AD. We combined behavioral, electroencephalography (EEG), and eye movement recordings during the performance of a spatial navigation task (a virtual version of the Morris Water Maze adapted to humans). Participants (69-88 years old) with amnesic mild cognitive impairment-Clinical Dementia Rating scale (aMCI-CDR 0.5) were selected as probable early AD (eAD) by a neurologist specialized in dementia. All patients included in this study were evaluated at the CDR 0.5 stage but progressed to probable AD during clinical follow-up. An equal number of matching healthy controls (HCs) were evaluated while performing the navigation task. Data were collected at the Department of Neurology of the Clinical Hospital of the Universidad de Chile and the Department of Neuroscience of the Faculty of Universidad de Chile. Participants with aMCI preceding AD (eAD) showed impaired spatial learning and their visual exploration differed from the control group. eAD group did not clearly prefer regions of interest that could guide solving the task, while controls did. The eAD group showed decreased visual occipital evoked potentials associated with eye fixations, recorded at occipital electrodes. They also showed an alteration of the spatial spread of activity to parietal and frontal regions at the end of the task. The control group presented marked occipital activity in the beta band (15-20 Hz) at early visual processing time. The eAD group showed a reduction in beta band functional connectivity in the prefrontal cortices reflecting poor planning of navigation strategies. We found that EEG signals combined with visual-spatial navigation analysis, yielded early and specific features that may underlie the basis for understanding the loss of functional connectivity in AD. Still, our results are clinically promising for early diagnosis required to improve quality of life and decrease healthcare costs.

Examining Distinctive Working Memory Profiles in Chinese Children With Predominantly Inattentive Subtype of Attention-Deficit/Hyperactivity Disorder and/or Reading Difficulties

Although evidence has shown that both RD and ADHD-I children suffer from working memory problems, inconsistencies in impaired modalities have been reported. This study aimed to (1) compare the three WM domains (i.e., verbal WM, visual-spatial WM, and behavioral WM) among pure ADHD-I, pure RD, comorbid ADHD-I+RD, and typical control groups and (2) examine the impact of comorbidity on the three WM domains. A Chinese sample of participants from Hong Kong included 29 children in the ADHD-I group, 78 children in the RD group, 31 children in the comorbid group (ADHD-I+RD), and 64 children in the TD control group. All participants completed the assessments individually. The findings showed that the children with ADHD-I and/or RD exhibited diverse cognitive profiles. In particular, RD was associated with verbal and visual-spatial working memory deficits, while ADHD-I was associated with behavioral working memory deficits. Interestingly, the comorbid condition demonstrated additive deficits of the two disorders but with greater deficits in behavioral working memory. These findings support the cognitive subtype hypothesis and provide a clearer picture of the distinctive working memory profiles of different groups, allowing for the development of intervention programs in the future.

Funkcjonowanie poznawcze, zmiany gałkoruchowe i oczne w przebiegu prawidłowego starzenia się i procesu otępiennego typu alzheimerowskiego – przegląd badań

Cognitive Functioning, Eyesight and Eye Movement Changes in the Course of Normal Aging and the Alzheimer’s Dementia Process – a Review of Research Polish society is aging. Currently, people over 65 constitute 16.5% of the population. Along with changes in the population structure, the number of patients with dementia disorders increases. Every year, worldwide, there are nearly 4.6 million new patients diagnosed with dementia, including the Alzheimer’s disease (AD). The purpose of this article is to review research studies that analyze visual-spatial deficits, eyesight and eye movement changes in normally aging people and in patients with AD. With age, various cognitive deficits appear, including visualspatial deficits of perception of complex stimuli, copying figures and visual construction, coordination and visual-spatial processing. So far, a number of studies have been conducted which show that people with AD have a thinner retinal nerve fiber layer. Macular volume and thickness reduction is also observed, which correlates with the severity of cognitive impairment. Research also points to the association of AD with eye movement disorders. Patients in this group make a greater number of errors in anti-saccade tasks as compared to healthy people. Typical for AD are delayed saccades and slow vertical saccade movement, lower accuracy and longer latency time, as well as lower saccadic inhibition as compared to normally ageing people. Identification of eye movement disorders can not only provide information on the severity of the disease but also make it possible to track its progression, and thus, probably, evaluate the effectiveness of the treatment. Further studies will verify the diagnostic value of the retinal changes as an AD marker and the eye movement disorders in determining the severity of the disease, monitoring its course and assessing the effectiveness of the treatment.

Visuo-Spatial Abilities and Phonological Awareness as Predictors of Reading Accuracy in Arabic Children With and Without Dyslexia

ABSTRACT Although the link between developmental dyslexia and visual-spatial deficit has been recurrently highlighted, the relationship between visual-spatial abilities and reading performance is still a controversial issue, considering the orthographic variability of the language being learned. This study aimed to examine whether visuo-spatial abilities (i.e. attention, short-term memory, and relations) contribute significantly to predicting word and pseudo-word reading independently of phonological awareness in Arabic speaking children in grades 4 and 5. An inter-groups comparison between two groups of readers comprising typical readers (n = 44) and children with dyslexia (n = 32). All participants were tested in phonological (phonological awareness) and visuo-spatial measures (visual short-term memory test, visuo-spatial attention, and visuo-spatial relations). Results showed that typical readers outperformed the group of dyslexics in all the phonological and visuo-spatial measures. Visuo-spatial abilities were also a contributing factor in predicting word reading after controlling for phonological awareness, age, and non-verbal reasoning. Findings indicate that vowelised word reading in Arabic is heavily underpinned by phonological awareness and visuo-spatial abilities, found to be impaired in a group with dyslexia. Findings are viewed in the frame that reveals the integrated roles of phonological awareness and visual and spatial abilities in reading development.

Cognitive Deficits in Pediatric Craniopharyngioma: An Updated Review

AbstractCraniopharyngiomas (CP) are brain tumors that often occur in children and adolescent that results in many neurological and endocrinological disorders. The aim of this systematic review is to provide updated version of studies used to formalize standard tests used for cognitive impairment in pediatric patients with craniopharyngioma. A systematic review was conducted in PubMed, EBSCO, ProQuest, Science Direct, Wiley Online, and Springer to identify studies assessing cognitive impairment in pediatric patients with craniopharyngioma. Academic and learning dysfunctions were reported in seven studies among 41 of 178 patients (23%). Visual–spatial deficits were reported in six studies. Speech and verbal dysfunctions were reported in three studies. Memory deficits were reported in eight studies among 61 of 197 patients (31%). Motor dysfunctions were reported in five studies. Sleep related issues were reported in four studies among 33 of 70 patients (47.1%). Patients with treated pediatric CP demonstrate a high incidence of neurological deficits including cognitive dysfunctions. Academic and learning dysfunctions, visual–spatial deficits, speech and verbal dysfunctions, memory deficits, and sleep-related issues were the most commonly reported cognitive deficits in the present study.

Multimodal MRI staging for tracking progression and clinical-imaging correlation in sporadic Creutzfeldt-Jakob disease

Diffusion imaging is very useful for the diagnosis of sporadic Creutzfeldt-Jakob disease, but it has limitations in tracking disease progression as mean diffusivity changes non-linearly across the disease course. We previously showed that mean diffusivity changes across the disease course follow a quasi J-shaped curve, characterized by decreased values in earlier phases and increasing values later in the disease course. Understanding how MRI metrics change over-time, as well as their correlations with clinical deficits are crucial steps in developing radiological biomarkers for trials. Specifically, as mean diffusivity does not change linearly and atrophy mainly occurs in later stages, neither alone is likely to be a sufficient biomarker throughout the disease course. We therefore developed a model combining mean diffusivity and Volume loss (MRI Disease-Staging) to take into account mean diffusivity’s non-linearity. We then assessed the associations between clinical outcomes and mean diffusivity alone, Volume alone and finally MRI Disease-Staging.In 37 sporadic Creutzfeldt-Jakob disease subjects and 30 age- and sex-matched healthy controls, high angular resolution diffusion and high-resolution T1 imaging was performed cross-sectionally to compute z-scores for mean diffusivity (MD) and Volume. Average MD and Volume were extracted from 41 GM volume of interest (VOI) per hemisphere, within the images registered to the Montreal Neurological Institute (MNI) space. Each subject’s volume of interest was classified as either “involved” or “not involved” using a statistical threshold of ± 2 standard deviation (SD) for mean diffusivity changes and/or −2 SD for Volume. Volumes of interest were MRI Disease-Staged as: 0 = no abnormalities; 1 = decreased mean diffusivity only; 2 = decreased mean diffusivity and Volume; 3 = normal (“pseudo-normalized”) mean diffusivity, reduced Volume; 4 = increased mean diffusivity, reduced Volume. We correlated Volume, MD and MRI Disease-Staging with several clinical outcomes (scales, score and symptoms) using 4 major regions of interest (Total, Cortical, Subcortical and Cerebellar gray matter) or smaller regions pre-specified based on known neuroanatomical correlates.Volume and MD z-scores correlated inversely with each other in all four major ROIs (cortical, subcortical, cerebellar and total) highlighting that ROIs with lower Volumes had higher MD and vice-versa. Regarding correlations with symptoms and scores, higher MD correlated with worse Mini-Mental State Examination and Barthel scores in cortical and cerebellar gray matter, but subjects with cortical sensory deficits showed lower MD in the primary sensory cortex. Volume loss correlated with lower Mini-Mental State Examination, Barthel scores and pyramidal signs. Interestingly, for both Volume and MD, changes within the cerebellar ROI showed strong correlations with both MMSE and Barthel. Supporting using a combination of MD and Volume to track sCJD progression, MRI Disease-Staging showed correlations with more clinical outcomes than Volume or MD alone, specifically with Mini-Mental State Examination, Barthel score, pyramidal signs, higher cortical sensory deficits, as well as executive and visual-spatial deficits. Additionally, when subjects in the cohort were subdivided into tertiles based on their Barthel scores and their percentile of disease duration/course (“Time-Ratio”), subjects in the lowest (most impaired) Barthel tertile showed a much greater proportion of more advanced MRI Disease-Stages than the those in the highest tertile. Similarly, subjects in the last Time-Ratio tertile (last tertile of disease) showed a much greater proportion of more advanced MRI Disease-Stages than the earliest tertile. Therefore, in later disease stages, as measured by time or Barthel, there is overall more Volume loss and increasing MD.A combined multiparametric quantitative MRI Disease-Staging is a useful tool to track sporadic Creutzfeldt-Jakob- disease progression radiologically.

Dementia with Lewy bodies and Parkinson’s disease dementia-two independent disorders or one clinical entity within a clinical spectrum of synucleinopathies?

Abstract Introduction: Introduction: Both dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) are important dementia syndromes that overlap in their clinical features and clinical course, neuropathological abnormalities, and also therapeutic approach. Nevertheless it is still unclear whether DLB and PDD are two different disorders that require differentiation or are one clinical entity within a spectrum of Lewy body disease. Currently these disorders are mainly distinguished on the basis of the relative timing of the onset of symptoms of dementia and parkinsonism. The present paper presents current concepts on the pathogenesis of both disorders and their possible overlap. Material and methods: Online databases in the field of DLB and PDD were searched for to find potentially eligible articles. Only most recent articles published after the year 2000 were chosen. Results: The clinical features of DLB and PDD are similar and include dementia with hallucinations and cognitive fluctuations, as well as parkinsonian signs. Also cognitive deficits are similar in PDD and in DLB, with predominance of executive dysfunction, visual-spatial deficits and memory impairment. Neuropathological changes in both disorders involve the presence of Lewy bodies and Lewy neurites within brainstem, limbic and neocortex, as well as loss of midbrain dopamine cells, and loss of cholinergic neurons in the nuclei of ventral forebrain. Conclusions: Similarities in clinical manifestation, neuropsychological deficits and neuropathological abnormalities may suggest that both DLB and PDD are two different phenotypes of the same disorder. This review article presents current knowledge on similarities and differences between these two clinical entities and raises the question whether they require differentiation or not.

Relationship between Visual Perception and Microstructural Change of the Superior Longitudinal Fasciculus in Patients with Brain Injury in the Right Hemisphere: A Preliminary Diffusion Tensor Tractography Study.

Right hemisphere brain damage often results in visual-spatial deficits. Because various microstructural changes of the superior longitudinal fasciculus (SLF) after a stroke in the right hemisphere affect visual perception, including neglect, the present study investigates the relationship between both microstructural change and lateralization of SLF and visual perception, using diffusion tensor imaging (DTI) in patients with lesions in the right hemisphere. Eight patients with strokes (five patients with intracranial hemorrhage, and three patients with infarction; mean age of 52.5 years) and 16 mean-age-matched healthy control subjects were involved in this study. The visual perception of all eight patients was assessed with the motor-free visual perception test (MVPT), and their SLFs were reconstructed using DTI. The results showed that there was a significant difference between the DTI parameters of the patients and the control subjects. Moreover, patients with microstructural damage to the right SLF showed impairment of visual perception. In patients with damage to both the dorsal and ventral pathways of the right SLF, spatial neglect was present. However, although a leftward SLF asymmetry was revealed in our patients, this lateralization did not show a relationship with visual perception. In conclusion, the microstructural changes of the right SLF play an important role in visual perception, and both pathways contribute to spatial neglect, but leftward lateralization of the right SFL activity after a stroke does not contribute to general visual perception.

Progressive aphasia, apraxia of speech and agraphia in corticobasal degeneration: A 12-case series clinical and neuropsychological descriptive study.

Despite initial underreporting of language dysfunctions in corticobasal syndrome (CBS), aphasia is now recognized as a frequent feature of this disease. Aphasia in CBS seems clinically overlying to a non-fluent/agrammatic primary progressive aphasia (nfaPPA), which is also a clinical phenotype associated with corticobasal degeneration (CBD) pathology. However, the clinical features of aphasia in CBS still remain poorly delineated, resulting in misjudgements in the differential diagnosis from a PPA presentation of the disease. To investigate the language disorders of this syndrome, also through a systematic examination of recoding skills (reading, written spelling and repetition) and articulatory disturbances, which have been rarely examined in previous studies. We present a clinical and neuropsychological descriptive study of the language impairments in a case series of 12 aphasic patients with a clinical diagnosis of CBS. Language assessment was conducted by means of the Esame NeuroPsicologico dell'Afasia, a comprehensive Italian battery for language functions, the Token Test, and the Apraxia of Speech Rating Scale. The language profile of the patients showed a severe expressive language disorder, characterized by non-fluent speech, apraxia of speech (AoS) with predominant stuttering-like dysfluencies, spatial/apraxic agraphia, lack of word-finding and defective sentence repetition. Severe limb apraxia, visual-spatial deficit and alien hand syndrome were also present. Neuroimaging showed bilateral left asymmetric atrophies and hypometabolism in the frontal premotor, parietal posterior and temporal areas. These findings suggest that aphasia in CBS might present as a 'mixed PPA', instead of an nfaPPA as previously stated, showing a combination of features of the nfa and logopenic variants of the PPA, associated with AoS, stuttering and agraphia, which might be additional important cognitive markers for the clinical diagnosis of CBS and discriminating features of an nfaPPA presentation of a CBD. These results might also suggest specific intervention areas in the rehabilitation of patients with CBS. What this paper adds What is already known on the subject Language disorders in CBS patients usually present clinically overlying to an nfaPPA, which is also a clinical phenotype associated with CBD pathology, according to recent diagnostic criteria. However, the clinical features of aphasia in CBS still remain poorly delineated, and this raises difficulties and misjudgements for clinicians in the differential diagnosis from a PPA presentation of the disease. What this paper adds to existing knowledge This study shows that the language profile of our CBS patients was characterized by severe expressive language disorders, with non-fluent speech, apraxia of speech (AoS) with predominant stuttering-like dysfluencies, spatial/apraxic agraphia, lack of word-finding, and defective sentence repetition. These findings suggest that aphasia in CBS might present as a 'mixed PPA', rather than an nfaPPA as previously stated, showing a combination of features of the nfa and logopenic variants of the PPA associated with AoS, stuttering and agraphia. What are the potential or actual clinical implications of this work? These results suggest that AoS, stuttering and agraphia might be important additional cognitive markers for the clinical diagnosis of CBS, and discriminating features of an nfaPPA presentation of a CBD. The language disorders exhibited in the present study might also support speech and language therapists in targeting specific intervention areas in the rehabilitation of patients with CBS.

Effects of temporal frequency on binocular deficits in amblyopia

Amblyopia is associated with a range of well-known visual spatial deficits, which include reduced contrast sensitivity, spatial distortions, interocular suppression, and impaired stereopsis. Previous work has also pointed to deficits in processing dynamic visual information, but it is unknown whether these deficits influence performance under binocular conditions. We examined the effects of temporal modulation on contrast sensitivity and binocular interactions in a preliminary study of 8 adults with amblyopia and 14 normally-sighted control subjects. For each observer, we measured interocular balance and stereopsis thresholds with binocular flicker across a range of four temporal (0, 4, 7.5, and 12 Hz) and spatial (1, 2, 4, and 8 cpd) frequencies. Interocular balance was estimated by varying the relative contrast of dichoptic letter pairs to produce perceptual reports of each letter with equal frequency, and stereopsis thresholds were measured by determining the minimum disparity at which subjects identified a front-depth target with 75% accuracy. Consistent with previous findings, we observed greater interocular imbalance and impaired stereoacuity at high spatial frequencies in amblyopes. In contrast, the effects of temporal frequency on performance were smaller: across both groups, interocular imbalance was largest at mid-to-low temporal frequencies, and stereopsis thresholds were unaffected by temporal frequency. Our results suggest that there may be a previously unreported effect of temporal frequency on interocular balance, as well as a possible dissociation between the effects of flicker on interocular balance and stereopsis.

C-15 Serotonergic System Activity and BPSD in Alzheimer’s Disease Pathogenesis: A Systematic Review

Abstract Objective The 5-hydroxytryptamine (5-HT) system is heavily implicated in behavioral and psychological symptoms of dementia (BPSD), with substantial bases for ongoing research in Alzheimer’s disease (AD). This system is directly tied to the hypothalamic-pituitary-adrenal axis. This systematic review aims to accomplish the following objectives: 1) introduce noteworthy BPSD found in AD; 2) synthesize research on 5-HT and BPSD in AD; 3) discuss neuropsychological sequelae of serotonergic dysregulation in AD; and, 4) report future research directions. Data Selection Data Selection: We conducted a literature search of the Medline, PubMed, psychINFO, and Google Scholar databases using the following keywords: Alzheimer’s*, seroton* (serotonin, serotonergic), 5-HT* (5-HTR, 5-HTT*), neuropsychology, behavior*, cogniti*. From the list of studies obtained through this search, we then employed the following inclusion criteria: 1) individuals in study had a formal diagnosis of probable or suspected AD; 2) individuals in study had not previously experienced head trauma, recurrent seizure, or other neurological insult; 3) sample did not include participants with comorbid personality disorders. Data Synthesis Findings suggest that serotonin’s receptors (5-HTRs), transporter (5-HTT), metabolite (5-HTP), and transporter-linked polymorphic region (5-HTTLPR) are linked to depression, anxiety, hyperactivity/impulsivity, aggression, and apathy in AD. Further, 5-HT and resultant BPSD are implicated in numerous cognitive functions including but not limited to decision-making, visual-spatial deficits, attention and vigilance, episodic memory, global cognitive function. Conclusions Substantial evidence exists implicating the serotonergic system in BPSD in AD. By understanding the impact of 5-HT on disease trajectory, neurocognitive functioning, and neuropsychological test performance, clinicians can ensure that appropriate recommendations are made for psychosocial and pharmacological intervention.

C-55 Normal Brain Cells in Abnormal Places: Contributions of Conjoint Neuropsychological, Pediatric, Neurologic, and Psychiatric Assessment in the Diagnosis and Behavioral Management of Pediatric Subependymal Heterotopia

Abstract Objective Subependymal heterotopia (SH) is a development brain malformation from abnormal neuronal proliferation and migration resulting in developmental delays and focal childhood epilepsy (Barkovich, 2000). SH results from the interruption of normal gray matter migration beneath the ependyma of the lateral ventricles. Most males are spontaneously aborted, and although there is some genetic uncertainty, affected females are thought to be X-linked (Xq28) recessive (Mitchell, et.al., 2000). SH prevalence in epileptic children with brain dysgenesis is between 13-20% and manifests in motor, visual-spatial, cognitive, and psychological deficits (Data, et.al., 2018). Method We present a case study of a seventeen-year-old female who was diagnosed at age eight with ADD and LD by self-report check-lists and achievement tests. Behavioral irregularities and seizure onset lead pediatrics to request neuropsychological testing. Findings revealed cognitive and emotional impairment and consequently further medical evaluation was recommended. Pediatric, neurological, and psychiatric examination, EEG, and MRI confirmed SH along the lateral margin of the right lateral ventricle. Results Psychometric testing revealed low average FSIQ, PRI, and PSI, impaired arithmetic operations and problem solving, graphomotor deficits, motor speed and executive/planning difficulties, emotional dysregulation, age-inappropriate interpersonal skills, and social-behavioral regression. Conclusions Neuropsychological assessment provided clear evidence of cognitive impairment beyond the initial diagnoses, suggested lateralized dysfunction, and implicated frontal and subcortical behavioral correlates not explained by other dispositional variables. Comprehensive neuropsychological assessment provided detailed information toward conjoint treatment planning by pediatrics, neurology, psychology, psychiatry, and teachers. Findings provided meaningful diagnostic clarification of SH and furthered clinical understanding of this adolescent’s social, academic, neuropsychological, and psychiatric needs.

1454-P: Cerebral Glutathione Is Associated with Insulin Resistance in Older Individuals

Glutathione (GSH) is the primary defense against oxidative stress through its role in reducing reactive oxygen species (ROS) in the body, and its levels have been shown to be lower in both metabolic disease and aging. In this study, we sought to determine whether GSH levels in the human brain are lower in older individuals and whether these levels are associated with metabolic changes that come with age, such as increasing insulin resistance. 14 young (age 30.1 ±3.2 years, BMI 26.1 ±0.8 kg/m2, A1c 5.3% ±0.1, HOMA-IR 1.6 mg(μU)/dL(mL) ±0.2) and 9 old (age 73.7 ±1.8, BMI 28.1 ±1.6, A1c 5.6 ±0.1, HOMA-IR 2.9 ±0.7) individuals underwent an oral glucose tolerance test as well as magnetic resonance spectroscopy (MRS) scanning at 4T for measurement of intracerebral GSH levels in the prefrontal cortex and striatum. Older individuals had higher levels of plasma ROS compared to younger individuals (P<0.001); however, there were no differences in plasma GSH levels (P=0.15). Intracerebral GSH levels (normalized to creatine(cr)) were not different between groups (P=0.76 prefrontal cortex, P=0.53 striatum). Amongst the older individuals, cerebral GSH/cr levels correlated inversely with HOMA-IR in both the striatum (r = -0.74, P=0.04) as well as prefrontal cortex (r= -0.95, P<0.001). Moreover, amongst older individuals, intracerebral GSH levels correlated inversely with performance on several measures of visual-spatial memory including the spatial working memory task (ρ= -0.9, P=0.003). There were no relationships between HOMA-IR and cerebral GSH levels amongst the younger individuals. Our findings indicate that amongst older individuals, increased insulin resistance is associated with diminished intracerebral GSH levels as well as visual-spatial cognitive deficits. These findings suggest that intracerebral GSH levels may be a useful marker for assessing the impact of metabolic dysfunction on neurocognitive function. Disclosure J.J. Pach: None. D. Groskreutz: None. J. Leventhal: None. M. Knight: None. K. Jain: None. J. Hwa: None. L. Jiang: None. R. de Graaf: None. J. Hwang: None. Funding National Institutes of Health (P30AG021342)

“The case against specialized visual-spatial short-term memory”: Correction to Morey (2018).

Reports an error in "The case against specialized visual-spatial short-term memory" by Candice C. Morey (Psychological Bulletin, 2018[Aug], Vol 144[8], 849-883). In the article, the text describing the case reports of patient E. L. D. (Hanley, Pearson, & Young, 1990, Hanley, Young, & Pearson, 1991) the text should read that E. L. D. had difficulties compared to a control sample choosing which of 20 faces (rather than 12 faces) she had recently seen. Later in the same section, the text should read "she had little difficulty recognizing which of two familiar faces she had encountered in a recent experimental session . . . .", rather than unfamiliar. Discussion with the original authors of the case reports describing E. L. D. also clarified a methodological point in their original report (Hanley, et al., 1990). The original report says that E. L. D. was given a recognition test for which particular view of an object she observed a month later. This in fact meant that E. L. D. undertook the entire task a month later than the other tasks in the set, not that she received the recognition test a month after exposure. None of these errors impact Morey's (2018) conclusions, including the conclusion that E. L. D.'s case does not meet the criteria for an unambiguous, selective visual-spatial short-term memory deficit. (The following abstract of the original article appeared in record 2018-24700-001.) The dominant paradigm for understanding working memory, or the combination of the perceptual, attentional, and mnemonic processes needed for thinking, subdivides short-term memory (STM) according to whether memoranda are encoded in aural-verbal or visual formats. This traditional dissociation has been supported by examples of neuropsychological patients who seem to selectively lack STM for either aural-verbal, visual, or spatial memoranda, and by experimental research using dual-task methods. Though this evidence is the foundation of assumptions of modular STM systems, the case it makes for a specialized visual STM system is surprisingly weak. I identify the key evidence supporting a distinct verbal STM system-patients with apparent selective damage to verbal STM and the resilience of verbal short-term memories to general dual-task interference-and apply these benchmarks to neuropsychological and experimental investigations of visual-spatial STM. Contrary to the evidence on verbal STM, patients with apparent visual or spatial STM deficits tend to experience a wide range of additional deficits, making it difficult to conclude that a distinct short-term store was damaged. Consistently with this, a meta-analysis of dual-task visual-spatial STM research shows that robust dual-task costs are consistently observed regardless of the domain or sensory code of the secondary task. Together, this evidence suggests that positing a specialized visual STM system is not necessary. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Effects of virtual reality-based training with BTs-Nirvana on functional recovery in stroke patients: preliminary considerations

ABSTRACTAim of the study: Cognitive impairment occurs frequently in post-stroke patients. This study aimed to determine the effects of a virtual reality training (VRT) with BTs-Nirvana (BTsN) on the recovery of cognitive functions in stroke patients, using the Interactive-Semi-Immersive Program (I-SIP).Materials and methods: We enrolled 12 subjects (randomly divided into two groups: experimental group (EG); and control group (CG)), who attended the Laboratory of Robotic and Cognitive Rehabilitation of IRCCS Neurolesi of Messina from January to June 2016. The EG underwent a VRT with BTsN, whereas CG received a standard cognitive treatment. Both the groups underwent the same conventional physiotherapy program. Each treatment session lasted 45 minutes and was repeated three times a week for 8 weeks. All the patients were evaluated by a specific clinical-psychometric battery before (T0), immediately (T1), and one month (T2) after the end of the training.Results: At T1, the EG presented a greater improvement in the trunk control test (p = 0.03), the Montreal Cognitive Assessment (p = 0.01), the selective attention assessment scores (p = 0.01), the verbal memory (p = 0.03), and the visuospatial and constructive abilities (p = 0.01), as compared to CG. Moreover, such amelioration persisted at T2 only in the EG.Conclusions: According to these preliminary data, VRT with I-SIP can be considered a useful complementary treatment to potentiate functional recovery, with regard to attention, visual-spatial deficits, and motor function in patients affected by stroke.

A Review on Phonological Awareness and Visual-Spatial Ability among Children with Dyslexia

This review aims to present an overview of current research findings on the possible relationship between phonological awareness and visual-spatial skills among individuals with dyslexia. Narrative review of the relevant articles obtained through computerized searches of databases such as PubMed, PubMed Central (PMC) and Google Scholar which included articles from SAGE, Taylor & Francis and Massachusetts Institute of Technology (MIT) Press from the year 2000 to 2014. The key words were explored, both exclusively and in combination with each other, so as to provide a better understanding of the relationship between them among individuals with dyslexia. Although it is evident that there is a phonological deficit in individuals with dyslexia, however, it is inconclusive with regards to the visual-spatial deficit and strength. There is a consensus on the nature of phonological awareness skill deficits but not on the visual spatial abilities in dyslexia. In fact, the relationship between phonological awareness and visual spatial abilities in dyslexia is dependent on the area of visual ability measured. DOI : http://dx.doi.org./10.17576/JSKM-2018-20

A Review on Phonological Awareness and Visual-Spatial Ability among Children with Dyslexia

This review aims to present an overview of current research findings on the possible relationship between phonological awareness and visual-spatial skills among individuals with dyslexia. Narrative review of the relevant articles obtained through computerized searches of databases such as PubMed, PubMed Central (PMC) and Google Scholar which included articles from SAGE, Taylor & Francis and Massachusetts Institute of Technology (MIT) Press from the year 2000 to 2014. The key words were explored, both exclusively and in combination with each other, so as to provide a better understanding of the relationship between them among individuals with dyslexia. Although it is evident that there is a phonological deficit in individuals with dyslexia, however, it is inconclusive with regards to the visual-spatial deficit and strength. There is a consensus on the nature of phonological awareness skill deficits but not on the visual spatial abilities in dyslexia. In fact, the relationship between phonological awareness and visual spatial abilities in dyslexia is dependent on the area of visual ability measured. DOI : http://dx.doi.org./10.17576/JSKM-2018-20

Lower limbs heterometry correction in patients with osteoporosis and increased risk of falls.

Osteoporotic fractures are associated with a significant increase in morbidity, mortality and medical costs. There is also a strong link between fractures and increased mortality. Among effective measures for the prevention of falls, instability treatment surely plays a crucial role. Several factors contribute to instability, many of which are ageing-related: visual spatial deficit, strength reduction, weight imbalance with COP lateralization sometimes favoured by LLD (leg length discrepancy). It seems useful to detect an heterometry which could be corrected, if present. The aim of our work is to assess the responses of individuals with heterometry diagnosis to the wedge positioning, using the balance board Lizard 3.0®. In the period between January 2013 and September 2013, 52 patients were recruited with clinical heterometry >5 mm among those that were treated in the Recovery and Rehabilitation Agency's postural clinic of the Careggi Hospital Orthopedic Trauma Centre in Florence. Our measurements have revealed that there is a statistically significant correlation (p<0.5) between clinical limb shortening expressed in mm and location of the weight imbalance at the stabilometric examination at T0; our data shows that the majority of patients with clinical heterometry shows a weight imbalance on the longer limb. After heterometry correction, 21 patients showed a statistically significant reduction (p<0,01) in weight imbalance expressed in kg between T0 and T1 and have been assigned to group 1, the remaining 31 worsened and have been assigned to group 2. From the results of our study, it is clear that the correction of lower limbs heterometry shouldn't be based only on clinical measuring of the limbs length discrepancy, even if very accurate.

Alterations of gray and white matter morphology in obsessive compulsive disorder.

While the ethio-pathogenesis of Obsessive-Compulsive disorder (OCD) remains unknown, there is increased evidence of widespread structural alterations in both white and gray matter in OCD patients that include, but are not restricted, to abnormalities in cortico-striatal-thalamo-cortical (CSTC) regions. The objective of this study was to test the existence of structural alterations in both white and gray matter in a sample of OCD patients when compared with a group of non-clinical matched controls (NCC), using voxel-based morphometry (VBM). Fifteen patients with OCD and 15 NCC underwent MRI structural scanning. Frontal (increased gray matter in the middle frontal gyrus) and subcortical regions (increased white matter in the pallidum) were found to be affected in patients. Additionally, temporal-parietal regions were also found to be affected and highly correlated with OCD symptom severity (decrease of gray matter in the superior parietal lobe and white matter in the angular and superior temporal gyri). These alterations may be associated with prominent OCD symptoms, such as difficulties with inhibitory control (pallidum, angular gyrus), executive functioning (middle frontal gyris), compulsive checking (superior temporal gyrus) and visual-spatial deficits (superior parietal lobe).