Lasting improvements in left spatial neglect following a protocol combining neck-muscle vibration and voluntary arm movements: a case-study

Purpose: Beyond promising experimental results of sensory passive stimulations in spatial cognition disorders, some questions still remain regarding interests of these stimulations during the daily activities in neglect. The aim of this case-study was to evaluate the effects of a protocol combining left neck-muscle vibration with daily simple movements, like arm pointing movements, on perceptivo-locomotor deficits in a left spatial neglect patient.

Materials and methods: Two neuropsychological tests, one subjective straight-ahead pointing (SSA) test and one wheelchair navigation test were carried out before the combination protocol, immediately after, 1?h later, and 24?h later.

Results: The results showed a reduction of neglect spatial bias following the protocol lasted at least 24?h in all the tests (except for the SSA test due to the unavailability of the pointing device).

Conclusions: The range of improvements in the symptoms of spatial neglect suggests that this therapeutic intervention based on the combining neck-muscle vibration to voluntary arm movements could be a useful treatment for this condition. One of future investigation axes should be the development of a vibratory tool in order to facilitate the combining this proprioceptive stimulation to daily activities.

• Implications for rehabilitation

• Spatial neglect is a perplexing neuropsychological syndrome, affecting different domains of spatial cognition and impacting also the functional domain.

• The treatments based on neck-muscle vibration are simple to use, non-invasive and requires none active participation of patient.

• A therapeutic intervention based on the combining left neck-muscle vibration and voluntary arm movements in a left-spatial-neglect show a lasting reduction of symptoms especially in daily activities.

• The combination of treatments based on the Bottom–Up approach opens innovative perspectives in rehabilitation.

     

Exploring the effectiveness of a specialized therapy programme for burnout using subjective report and biomarkers of stress

The increasing prevalence of stress-related disorders such as burnout urges the need for specialized treatment approaches. Programmes combining psychotherapy and regenerative interventions emerge to be the most successful. However, evaluated therapy programmes are scarce and usually involve subjective symptom quantification without consideration of physiologic parameters. The aim of the present exploratory, single-group study was the multimodal investigation of the effectiveness of a specialized holistic therapy programme by assessing symptoms and biological markers of chronic stress. Seventy-one in-patients (39 men/32 women; age 46.8 ± 9.9 years) of a specialized burnout ward with the additional diagnosis of burnout (Z73.0) in conjunction with a main diagnosis of depressive disorder (F32 or F33) according to the International Classification of Diseases (ICD)-10 were included in the study. In addition to symptomatology, the stress-responsive biomarkers heart rate variability (HRV) and serum brain-derived neurotrophic factor (BDNF) were measured in patients at admittance to and discharge from the burnout ward applying a 6-week specialized treatment programme. At discharge, patients showed a significant reduction of symptom burden and a significant increase in serum BDNF, while HRV remained unchanged. The findings implicate that the therapy programme may have beneficial effects on symptomatology and neuroplasticity of patients with burnout. As therapy was often supplemented by psychopharmacological treatment, a relevant influence of antidepressant medication especially on BDNF has to be considered.     

Invasive Techniken der Fertilitätsprotektion – was eignet sich für wen?

Gynäkologische Endokrinologie - Zu den invasiven Techniken der Fertilitätsprotektion zählen die ovarielle Stimulation mit nachfolgender Eizellpunktion, die ovarielle Gewebeentnahme...     

Response to Rady re: Religion and Neuroscience

Neurocritical Care -     

The association of stroke severity with health-related quality of life in survivors of acute cerebrovascular disease and their informal caregivers during the first year post stroke: a survey study

Quality of Life Research - To describe the health-related quality of life (HRQoL) of caregivers and survivors of transient ischaemic attack (TIA) and stroke during one year post discharge in...     

Evaluation of the Parameters Underlying the Decision by Adult Patients to Opt for Lingual Therapy: an International Comparison

BACKGROUND: The present study is the first instance of patients having been questioned on the criteria applied in their decision for therapy with lingual brackets and on the sources of information available to them within the framework of an international comparison prior to the start of therapy by means of a standardized questionnaire. PATIENTS AND METHOD: 68 patients (19 male, 49 female; mean age 32.4 years, range 19.8 to 60.0 years, SD 9.7) were interviewed. RESULTS: Therapy with lingual brackets was more important to the patients in the present study for professional than for private reasons: The further the patients were from the typical "braces age", the more important was treatment with an invisible appliance from the professional standpoint. The patients' educational level had no influence on the decision for a fixed lingual appliance. There was no significant difference between the German and the French patients in the decision-making criteria of adult patients and the sources of information available to them in the context of the lingual technique. CONCLUSION: The information available through the media on the lingual technique is inadequate in both countries.