Theta burst stimulation improves overt visual search in spatial neglect independently of attentional load

Visual neglect is considerably exacerbated by increases in visual attentional load. These detrimental effects of attentional load are hypothesised to be dependent on an interplay between dysfunctional inter-hemispheric inhibitory dynamics and load-related modulation of activity in cortical areas such as the posterior parietal cortex (PPC). Continuous Theta Burst Stimulation (cTBS) over the contralesional PPC reduces neglect severity. It is unknown, however, whether such positive effects also operate in the presence of the detrimental effects of heightened attentional load. Here, we examined the effects of cTBS on neglect severity in overt visual search (i.e., with eye movements), as a function of high and low visual attentional load conditions. Performance was assessed on the basis of target detection rates and eye movements, in a computerised visual search task and in two paper-pencil tasks. cTBS significantly ameliorated target detection performance, independently of attentional load. These ameliorative effects were significantly larger in the high than the low load condition, thereby equating target detection across both conditions. Eye movement analyses revealed that the improvements were mediated by a redeployment of visual fixations to the contralesional visual field. These findings represent a substantive advance, because cTBS led to an unprecedented amelioration of overt search efficiency that was independent of visual attentional load.

Analysis of left ventricular function of the mouse heart during experimentally induced hyperthyroidism and recovery

Many of the clinical manifestations of hyperthyroidism are due to the ability of thyroid hormones to alter myocardial contractility and cardiovascular hemodynamics, leading to cardiovascular impairment. In contrast, recent studies highlight also the potential beneficial effects of thyroid hormone administration for clinical or preclinical treatment of different diseases such as atherosclerosis, obesity and diabetes or as a new therapeutic approach in demyelinating disorders. In these contexts and in the view of developing thyroid hormone-based therapeutic strategies, it is, however, important to analyze undesirable secondary effects on the heart. Animal models of experimentally induced hyperthyroidism therefore represent important tools for investigating and monitoring changes of cardiac function. In our present study we use high-field cardiac MRI to monitor and follow-up longitudinally the effects of prolonged thyroid hormone (triiodothyronine) administration focusing on murine left ventricular function. Using a 9.4 T small horizontal bore animal scanner, cinematographic MRI was used to analyze changes in ejection fraction, wall thickening, systolic index and fractional shortening. Cardiac MRI investigations were performed after sustained cycles of triiodothyronine administration and treatment arrest in adolescent (8 week old) and adult (24 week old) female C57Bl/6 N mice. Triiodothyronine supplementation of 3 weeks led to an impairment of cardiac performance with a decline in ejection fraction, wall thickening, systolic index and fractional shortening in both age groups but with a higher extent in the group of adolescent mice. However, after a hormonal treatment cessation of 3 weeks, only young mice are able to partly restore cardiac performance in contrast to adult mice lacking this recovery potential and therefore indicating a presence of chronically developed heart pathology.

Ventilation/perfusion SPECT or SPECT/CT for lung function imaging in patients with pulmonary emphysema?

PURPOSE To evaluate the utility of attenuation correction (AC) of V/P SPECT images for patients with pulmonary emphysema. MATERIALS AND METHODS Twenty-one patients (mean age 67.6 years) with pulmonary emphysema who underwent V/P SPECT/CT were included. AC/non-AC V/P SPECT images were compared visually and semiquantitatively. Visual comparison of AC/non-AC images was based on a 5-point likert scale. Semiquantitative comparison assessed absolute counts per lung (aCpLu) and lung lobe (aCpLo) for AC/non-AC images using software-based analysis; percentage counts (PC = (aCpLo/aCpLu) × 100) were calculated. Correlation between AC/non-AC V/P SPECT images was analyzed using Spearman's rho correlation coefficient; differences were tested for significance with the Wilcoxon rank sum test. RESULTS Visual analysis revealed high conformity for AC and non-AC V/P SPECT images. Semiquantitative analysis of PC in AC/non-AC images had an excellent correlation and showed no significant differences in perfusion (ρ = 0.986) or ventilation (ρ = 0.979, p = 0.809) SPECT/CT images. CONCLUSION AC of V/P SPECT images for lung lobe-based function imaging in patients with pulmonary emphysema do not improve visual or semiquantitative image analysis.

Non-surgical treatment of pain associated with posterior tibial tendon dysfunction: study protocol for a randomised clinical trial

BACKGROUND Symptoms associated with pes planovalgus or flatfeet occur frequently, even though some people with a flatfoot deformity remain asymptomatic. Pes planovalgus is proposed to be associated with foot/ankle pain and poor function. Concurrently, the multifactorial weakness of the tibialis posterior muscle and its tendon can lead to a flattening of the longitudinal arch of the foot. Those affected can experience functional impairment and pain. Less severe cases at an early stage are eligible for non-surgical treatment and foot orthoses are considered to be the first line approach. Furthermore, strengthening of arch and ankle stabilising muscles are thought to contribute to active compensation of the deformity leading to stress relief of soft tissue structures. There is only limited evidence concerning the numerous therapy approaches, and so far, no data are available showing functional benefits that accompany these interventions. METHODS After clinical diagnosis and clarification of inclusion criteria (e.g., age 40-70, current complaint of foot and ankle pain more than three months, posterior tibial tendon dysfunction stage I & II, longitudinal arch flattening verified by radiography), sixty participants with posterior tibial tendon dysfunction associated complaints will be included in the study and will be randomly assigned to one of three different intervention groups: (i) foot orthoses only (FOO), (ii) foot orthoses and eccentric exercise (FOE), or (iii) sham foot orthoses only (FOS). Participants in the FOO and FOE groups will be allocated individualised foot orthoses, the latter combined with eccentric exercise for ankle stabilisation and strengthening of the tibialis posterior muscle. Participants in the FOS group will be allocated sham foot orthoses only. During the intervention period of 12 weeks, all participants will be encouraged to follow an educational program for dosed foot load management (e.g., to stop activity if they experience increasing pain). Functional impairment will be evaluated pre- and post-intervention by the Foot Function Index. Further outcome measures include the Pain Disability Index, Visual Analogue Scale for pain, SF-12, kinematic data from 3D-movement analysis and neuromuscular activity during level and downstairs walking. Measuring outcomes pre- and post-intervention will allow the calculation of intervention effects by 3×3 Analysis of Variance (ANOVA) with repeated measures. DISCUSSION The purpose of this randomised trial is to evaluate the therapeutic benefit of three different non-surgical treatment regimens in participants with posterior tibial tendon dysfunction and accompanying pes planovalgus. Furthermore, the analysis of changes in gait mechanics and neuromuscular control will contribute to an enhanced understanding of functional changes and eventually optimise conservative management strategies for these patients. TRIAL REGISTRATION ClinicalTrials.gov Protocol Registration System: ClinicalTrials.gov ID NCT01839669.

Tooth loss, chewing efficiency and cognitive impairment in geriatric patients.

BACKGROUND Patients with dementia have poorer oral health and fewer teeth than their peers without cognitive impairment. OBJECTIVE The hypothesis of this study is that the number of natural teeth and the chewing efficiency are associated with cognitive functioning. METHODS This cross-sectional study included 29 patients diagnosed with dementia aged 75 years or older and 22 controls who were either cognitively normal (n = 19) or with mild cognitive impairment (n = 3). Neuropsychological, nutritional and dental assessments were performed. The chewing efficiency was evaluated with a two-colour mixing test. RESULTS Demented patients and controls presented with a mean of 4.9 and 6.5 teeth, respectively (n.s.). The number of natural teeth was not associated with dementia (p = 0.553). Same results were found for age (p = 0.746) and sex (p = 0.901). The chewing efficiency by visual inspection proved worse in participants with dementia than in the controls (p < 0.011) and explained 9.3% of the variance in the diagnosis of dementia. Neither dental state nor chewing efficiency was related to the nutritional state. CONCLUSION Chewing efficiency seems stronger associated with cognitive impairment than the number of teeth. Hence, in a more holistic approach for the geriatric assessment, the dental examination may be complemented by a chewing efficiency test.

The influence of naturalistic, directionally non-specific motion on the spatial deployment of visual attention in right-hemispheric stroke

An impairment of the spatial deployment of visual attention during exploration of static (i.e., motionless) stimuli is a common finding after an acute, right-hemispheric stroke. However, less is known about how these deficits: a) are modulated through naturalistic motion (i.e., without directional, specific spatial features); and, b) evolve in the subacute/chronic post-stroke phase. In the present study, we investigated free visual exploration in three patient groups with subacute/chronic right-hemispheric stroke and in healthy subjects. The first group included patients with left visual neglect and a left visual field defect (VFD), the second patients with a left VFD but no neglect, and the third patients without neglect or VFD. Eye movements were measured in all participants while they freely explored a traffic scene without (static condition) and with (dynamic condition) naturalistic motion, i.e., cars moving from the right or left. In the static condition, all patient groups showed similar deployment of visual exploration (i.e., as measured by the cumulative fixation duration) as compared to healthy subjects, suggesting that recovery processes took place, with normal spatial allocation of attention. However, the more demanding dynamic condition with moving cars elicited different re-distribution patterns of visual attention, quite similar to those typically observed in acute stroke. Neglect patients with VFD showed a significant decrease of visual exploration in the contralesional space, whereas patients with VFD but no neglect showed a significant increase of visual exploration in the contralesional space. No differences, as compared to healthy subjects, were found in patients without neglect or VFD. These results suggest that naturalistic motion, without directional, specific spatial features, may critically influence the spatial distribution of visual attention in subacute/chronic stroke patients.

Temporal variations of dyspnea, fatigue, and lung function in chronic lung disease

Background. Research investigating symptom management in patients with chronic obstructive pulmonary disease (COPD) largely has been undertaken assuming the homeostatic construct, without regard to potential roles of circadian rhythms. Temporal relations among dyspnea, fatigue, peak expiratory flow rate (PEFR) and objective measures of activity/rest have not been reported in COPD. ^ Objectives. The specific aims of this study were to (1) explore the 24-hour patterns of dyspnea, fatigue, and PEFR in subjects with COPD; (2) examine the relations among dyspnea, fatigue, and PEFR in COPD; and (3) examine the relations among objective measures of activity/rest and dyspnea, fatigue, and PEFR in COPD. ^ Methods. The repeated-measures design involved 10 subjects with COPD who self-assessed dyspnea and fatigue by 100 mm visual analog scales, and PEFR by peak flow meter in their home 5 times a day for 8 days. Activity/rest was measured by wrist actigraphy. Single and population mean cosinor analyses and correlations were computed for dyspnea, fatigue, and PEFR; correlations were done among these variables and activity/rest. ^ Results. Circadian rhythms were documented by single cosinor analysis in 40% of the subjects for dyspnea, 60% for fatigue, and 60% for PEFR. The population cosinor analysis of PEFR yielded a significant rhythm (p < .05). The 8-day 24-hour means of dyspnea and fatigue was moderately correlated (r = .48, p < .01). Dyspnea and PEFR, and fatigue and PEFR, were weakly correlated in a negative way (r = −.11, p < .05 and r = −.15, p < .01 respectively). Weak to moderate correlations (r = .12–.34, p < .05) were demonstrated between PEFR and mean activity level measured up to 4 hours before PEFR measurement. ^ Conclusions. The findings suggest that (1) the dyspnea and fatigue experienced by COPD patients are moderately related, (2) there is a weak to modest positive relation between PEFR and activity levels, and (3) temporal variation in lung function may not affect the dyspnea and fatigue experienced by patients with COPD. Further research, examining the relations among dyspnea, fatigue, PEFR, and activity/rest is needed. Replication of this study is suggested with a larger sample size. ^

The contributions of the hippocampal formation, perirhinal cortex and areas TH/TF to object, spatial and contextual recognition memory in primates

Adult monkeys (Macaca mulatta) with lesions of the hippocampal formation, perirhinal cortex, areas TH/TF, as well as controls were tested on tasks of object, spatial and contextual recognition memory. ^ Using a visual paired-comparison (VPC) task, all experimental groups showed a lack of object recognition relative to controls, although this impairment emerged at 10 sec with perirhinal lesions, 30 sec with areas TH/TF lesions and 60 sec with hippocampal lesions. In contrast, only perirhinal lesions impaired performance on delayed nonmatching-to-sample (DNMS), another task of object recognition memory. All groups were tested on DNMS with distraction (dDNMS) to examine whether the use of active cognitive strategies during the delay period could enable good performance on DNMS in spite of impaired recognition memory (revealed by the VPC task). Distractors affected performance of animals with perirhinal lesions at the 10-sec delay (the only delay in which their DNMS performance was above chance). They did not affect performance of animals with areas TH/TF lesions. Hippocampectomized animals were impaired at the 600-sec delay (the only delay at which prevention of active strategies would likely affect their behavior). ^ While lesions of areas TH/TF impaired spatial location memory and object-in-place memory, hippocampal lesions impaired only object-in-place memory. The pattern of results for perirhinal cortex lesions on the different task conditions indicated that this cortical area is not critical for spatial memory. ^ Finally, all three lesions impaired contextual recognition memory processes. The pattern of impairment appeared to result from the formation of only a global representation of the object and background, and suggests that all three areas are recruited for associating information across sources. ^ These results support the view that (1) the perirhinal cortex maintains storage of information about object and the context in which it is learned for a brief period of time, (2) areas TH/TF maintain information about spatial location and form associations between objects and their spatial relationship (a process that likely requires additional time) and (3) the hippocampal formation mediates associations between objects, their spatial relationship and the general context in which these associations are formed (an integrative function that requires additional time). ^

STUDIES ON CHOLINERGIC FUNCTION AND MEMORY IN MICE (CHOLINOTOXINS, WORKING, REFERENCE MEMORY, RADIAL ARM MAZE)

Considerable evidence suggests that central cholinergic neurons participate in either acquisition, storage or retrieval of information. Experiments were designed to evaluate information processing in mice following either reversible or irreversible impairment in central cholinergic activity. The cholinergic receptor antagonists, atropine and methylatropine were used to reversibly inhibit cholinergic transmission. Irreversible impairment in central cholinergic function was achieved by central administration of the cholinergic-specific neurotoxins, N-ethyl-choline aziridinium (ECA) and N-ethyl-acetylcholine aziridinium (EACA).^ ECA and EACA appear to act by irreversible inhibition of high affinity choline uptake (proposed rate-limiting step in acetylcholine synthesis). Intraventricular administration of ECA or EACA produced persistent reduction in hippocampal choline acetyltransferase activity. Other neuronal systems and brain regions showed no evidence of toxicity.^ Mice treated with either ECA or EACA showed behavioral deficits associated with cholinergic dysfunction. Passive avoidance behavior was significantly impaired by cholinotoxin treatment. Radial arm maze performance was also significantly impaired in cholinotoxin-treated animals. Deficits in radial arm maze performance were transient, however, such that rapid and apparent complete behavioral recovery was seen during retention testing. The centrally active cholinergic receptor antagonist atropine also caused significant impairment in radial arm maze behavior, while equivalent doses of methylatropine were without effect.^ The relative effects of cholinotoxin and receptor antagonist treatment on short-term (working) memory and long-term (reference) memory in radial arm maze behavior were examined. Maze rotation studies indicated that there were at least two different response strategies which could result in accurate maze performance. One strategy involved the use of response algorithms and was considered to be a function of reference memory. Another strategy appeared to be primarily dependent on spatial working memory. However, all behavioral paradigms with multiple trails have reference memory requirements (i.e. information useful over all trials). Performance was similarly affected following either cholinotoxin or anticholinergic treatment, regardless of the response strategy utilized. In addition, rates of behavioral recovery following cholinotoxin treatment were similar between response groups. It was concluded that both cholinotoxin and anticholinergic treatment primarily resulted in impaired reference memory processes. ^

Servicios bibliotecarios accesibles para personas con discapacidad visual en la Universidad Nacional de La Plata, Argentina

El trabajo, de tipo descriptivo exploratorio, pretende conocer cuál es el estado en que se encuentran algunas de las bibliotecas universitarias de la UNLP para ofrecer un servicio accesible a personas con discapacidad visual. Se analiza qué servicios de este tipo poseen actualmente, con qué barreras se enfrentan los usuarios y qué soluciones se han implementado. A tal fin se indagará, por un lado, cómo están diseñados los sitios web de las bibliotecas elegidas, y por otro, cómo integran estas bibliotecas en sus servicios y productos documentales a estas personas, esto es, si cuentan con material bibliográfico y servicios accesibles. Por último, se esbozan algunas propuestas para superar la situación actual en estas bibliotecas universitarias

La orientación vocacional - ocupacional en sujetos con necesidades educativas especiales derivadas de la discapacidad visual en la etapa de transición escuela secundaria - Educación superior

Este trabajo está dirigido a indagar los factores asociados a las elecciones que realizan los sujetos con Necesidades Educativas Especiales derivadas de la Discapacidad Visual en la etapa de transición entre la escolaridad secundaria y las posibilidades de proseguir estudios superiores. Para este fin, se ha tomado en consideración que la Orientación Vocacional Ocupacional y la transición hacia la vida adulta adquieren características específicas en el caso de jóvenes que presentan Discapacidad Visual, particularmente en relación con la preparación para la continuación de estudios superiores. El interés de este trabajo reside en poder esclarecer la existencia de factores que facilitan u obstaculizan ese tránsito, a partir de la observación de sujetos disminuidos visuales y ciegos que finalizan sus estudios secundarios. Se trata de un tema que ha ocasionado interés y preocupación acerca de las estrategias a seguir para garantizar un ingreso y permanencia exitosos en los estudios superiores elegidos. Sin embargo, si se desconocen o más bien se carece de evidencia acerca de los factores a los que obedece el fenómeno descripto, es difícil poder diseñar estrategias de intervención que resulten adecuadas. Con el fin de tomar conocimiento sobre las problemáticas específicas de los jóvenes que finalizan sus estudios secundarios y que presentan Discapacidad Visual, se eligió una escuela especial de referencia en la mencionada discapacidad y se seleccionaron en ella los alumnos que participaron de este proyecto

Servicios bibliotecarios accesibles para personas con discapacidad visual en la Universidad Nacional de La Plata, Argentina

El trabajo, de tipo descriptivo exploratorio, pretende conocer cuál es el estado en que se encuentran algunas de las bibliotecas universitarias de la UNLP para ofrecer un servicio accesible a personas con discapacidad visual. Se analiza qué servicios de este tipo poseen actualmente, con qué barreras se enfrentan los usuarios y qué soluciones se han implementado. A tal fin se indagará, por un lado, cómo están diseñados los sitios web de las bibliotecas elegidas, y por otro, cómo integran estas bibliotecas en sus servicios y productos documentales a estas personas, esto es, si cuentan con material bibliográfico y servicios accesibles. Por último, se esbozan algunas propuestas para superar la situación actual en estas bibliotecas universitarias

La orientación vocacional - ocupacional en sujetos con necesidades educativas especiales derivadas de la discapacidad visual en la etapa de transición escuela secundaria - Educación superior

Este trabajo está dirigido a indagar los factores asociados a las elecciones que realizan los sujetos con Necesidades Educativas Especiales derivadas de la Discapacidad Visual en la etapa de transición entre la escolaridad secundaria y las posibilidades de proseguir estudios superiores. Para este fin, se ha tomado en consideración que la Orientación Vocacional Ocupacional y la transición hacia la vida adulta adquieren características específicas en el caso de jóvenes que presentan Discapacidad Visual, particularmente en relación con la preparación para la continuación de estudios superiores. El interés de este trabajo reside en poder esclarecer la existencia de factores que facilitan u obstaculizan ese tránsito, a partir de la observación de sujetos disminuidos visuales y ciegos que finalizan sus estudios secundarios. Se trata de un tema que ha ocasionado interés y preocupación acerca de las estrategias a seguir para garantizar un ingreso y permanencia exitosos en los estudios superiores elegidos. Sin embargo, si se desconocen o más bien se carece de evidencia acerca de los factores a los que obedece el fenómeno descripto, es difícil poder diseñar estrategias de intervención que resulten adecuadas. Con el fin de tomar conocimiento sobre las problemáticas específicas de los jóvenes que finalizan sus estudios secundarios y que presentan Discapacidad Visual, se eligió una escuela especial de referencia en la mencionada discapacidad y se seleccionaron en ella los alumnos que participaron de este proyecto

La orientación vocacional - ocupacional en sujetos con necesidades educativas especiales derivadas de la discapacidad visual en la etapa de transición escuela secundaria - Educación superior

Este trabajo está dirigido a indagar los factores asociados a las elecciones que realizan los sujetos con Necesidades Educativas Especiales derivadas de la Discapacidad Visual en la etapa de transición entre la escolaridad secundaria y las posibilidades de proseguir estudios superiores. Para este fin, se ha tomado en consideración que la Orientación Vocacional Ocupacional y la transición hacia la vida adulta adquieren características específicas en el caso de jóvenes que presentan Discapacidad Visual, particularmente en relación con la preparación para la continuación de estudios superiores. El interés de este trabajo reside en poder esclarecer la existencia de factores que facilitan u obstaculizan ese tránsito, a partir de la observación de sujetos disminuidos visuales y ciegos que finalizan sus estudios secundarios. Se trata de un tema que ha ocasionado interés y preocupación acerca de las estrategias a seguir para garantizar un ingreso y permanencia exitosos en los estudios superiores elegidos. Sin embargo, si se desconocen o más bien se carece de evidencia acerca de los factores a los que obedece el fenómeno descripto, es difícil poder diseñar estrategias de intervención que resulten adecuadas. Con el fin de tomar conocimiento sobre las problemáticas específicas de los jóvenes que finalizan sus estudios secundarios y que presentan Discapacidad Visual, se eligió una escuela especial de referencia en la mencionada discapacidad y se seleccionaron en ella los alumnos que participaron de este proyecto

Merit function for the evaluation of color uniformity in the far field of LED spot lights

The scope of the present paper is the derivation of a merit function which predicts the visual perception of LED spot lights. The color uniformity level Usl is described by a linear regression function of the spatial color distribution in the far field. Hereby, the function is derived from four basic functions. They describe the color uniformity of spot lights through different features. The result is a reliable prediction for the perceived color uniformity in spot lights. A human factor experiment was performed to evaluate the visual preferences for colors and patterns. A perceived rank order was derived from the subjects’ answers and compared with the four basic functions. The correlation between the perceived rank order and the basic functions was calculated resulting in the definition of the merit function Usl. The application of this function is shown by a comparison of visual evaluations and measurements of LED retrofit spot lamps. The results enable a prediction of color uniformity levels of simulations and measurements concerning the visual perception. The function provides a possibility to evaluate the far field of spot lights without individual subjective judgment. © (2014) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.