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Increase of frontal neuronal activity in chronic neglect after training in virtual reality
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.ORCID iD: 0000-0003-1650-8856
Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
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2018 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 138, no 4, p. 284-292Article in journal (Refereed) Published
Abstract [en]

Objectives: A third of patients with stroke acquire spatial neglect associated with poor rehabilitation outcome. New effective rehabilitation interventions are needed. Scanning training combined with multisensory stimulation to enhance the rehabilitation effect is suggested. In accordance, we have designed a virtual-reality based scanning training that combines visual, audio and sensori-motor stimulation called RehAtt((R)). Effects were shown in behavioural tests and activity of daily living. Here, we use fMRI to evaluate the change in brain activity during Posners Cuing Task (attention task) after RehAtt((R)) intervention, in patients with chronic neglect.

Methods: Twelve patients (mean age=72.7years, SD=6.1) with chronic neglect (persistent symptoms >6months) performed the interventions 3 times/wk during 5weeks, in total 15hours. Training effects on brain activity were evaluated using fMRI task-evoked responses during the Posners cuing task before and after the intervention.

Results: Patients improved their performance in the Posner fMRI task. In addition, patients increased their task-evoked brain activity after the VR interventions in an extended network including pre-frontal and temporal cortex during attentional cueing, but showed no training effects during target presentations.

Conclusions: The current pilot study demonstrates that a novel multisensory VR intervention has the potential to benefit patients with chronic neglect in respect of behaviour and brain changes. Specifically, the fMRI results show that strategic processes (top-down control during attentional cuing) were enhanced by the intervention. The findings increase knowledge of the plasticity processes underlying positive rehabilitation effects from RehAtt((R)) in chronic neglect.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018. Vol. 138, no 4, p. 284-292
Keywords [en]
cognitive rehabilitation, functional magnetic resonance imaging, neuronal plasticity, spatial neglect, virtual reality
National Category
Neurology
Identifiers
URN: urn:nbn:se:umu:diva-152199DOI: 10.1111/ane.12955ISI: 000443931400003PubMedID: 29770439OAI: oai:DiVA.org:umu-152199DiVA, id: diva2:1259926
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2019-05-07Bibliographically approved

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Ekman, UrbanFordell, HelenaEriksson, JohanLenfeldt, NiklasWåhlin, AndersEklund, AndersMalm, Jan
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Department of Integrative Medical Biology (IMB)Umeå Centre for Functional Brain Imaging (UFBI)Clinical NeuroscienceDepartment of Pharmacology and Clinical NeuroscienceDepartment of Radiation Sciences
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Acta Neurologica Scandinavica
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