Primates learn from feedback that surprises them, and in a recent investigation of how that happens, neurosurgeons have learned something new. The insight they gleaned from examining the response of specific brain tissues during a learning task may inform future rehabilitative therapies after stroke or traumatic brain injury.
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Collaborative stroke research study in January 2012 Archives of Physical Medicine & Rehabilitation shows bedside clinical evaluation can detect spatial neglect, a common disabling cognitive disorder that impedes recovery for 30 to 50% of stroke survivors.
West Orange, NJ. January 3, 2012. Researchers at Kessler Foundation and Seton Hall University report findings in the early diagnosis of acute spatial neglect, a hidden disability that is a common complication of stroke. In the weeks after stroke, 30-50% of stroke survivors cannot reliably report or respond to external events that take place in the space opposite the side of their brain injury. Called spatial neglect, this disorder is a problem with attention and action rather than vision. Often overlooked, it is associated with accidents, falls, safety problems and functional disability that impedes recovery.
According to Anna Barrett, MD, director of Stroke Rehabilitation Research at Kessler Foundation, this study is unique in its focus on patients in the acute phase. “Early detection of spatial neglect after stroke could enable cognitive interventions to improve function, and might prevent chronic disability,” explained Dr. Barrett. “Spatial neglect is often thought of as a visual problem, but it critically impairs action and movement.”
While the impact of weakness and paralysis are well recognized, the effects of hidden disabilities like spatial neglect are underestimated. “Spatial neglect doubles or triples the disability a stroke survivor with paralysis experiences,” said Dr. Barrett, ” and could make the difference between chronic dependence and successful return to work and life. That is why it is important to diagnosis early and include cognitive interventions in the rehabilitation plan.”
The study is unique in looking at correlations between laboratory tools and the bedside tools clinicians use to diagnose spatial-motor dysfunction. Investigators studied 51 consecutive inpatients with right brain stroke and left neglect, within a mean 22.3 days post-stroke. Each was evaluated with laboratory measures of perceptual-attentional and motor-intentional deficits and 2 bedside measures– the Behavioral Inattention Test (BIT)-conventional and the Catherine Bergego scale (CBS).
Researchers determined that these psychometric assessments may be used to identify specific motor-exploratory deficits in spatial neglect. Specifically, obtaining CBS-ME scores routinely might improve the detection of spatial action deficits so that clinicians can implement appropriate care and safety interventions. Without specific cognitive rehabilitation, spatial-action deficits may persist and cause chronic disability. “Much effort goes into hi-tech approaches,” commented Dr. Barrett. “This study, however, shows that clinical tools can be optimized for the bedside, to identify patients who need targeted management and therapy.”
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Kessler Foundation. “Advances In Early Diagnosis Of Spatial Neglect Following Stroke.” Medical News Today. MediLexicon, Intl., 4 Jan. 2012. Web.
5 Jan. 2012. <http://www.medicalnewstoday.com/releases/239849.php>
The loss of manganese could mean that calcium does not stick to bones and could cause osteoporosis. This is the new theory put forward by researchers at the University of Castilla-La Mancha (UCLM) in Spain after studying deer antlers. The hypothesis published this month in the ‘Frontiers of Bioscience’ journal still needs to be confirmed by the scientific community.
Through the study of deer antlers, researchers of the Research Institute of Hunting Resources (IREC, joint centre UCLM-CSIC-JCCM) suggest that the origin of osteoporosis could not be directly linked to the lack of calcium but rather to the lack of a mineral essential to calcium absorption. In particular they believe that this could be manganese, according to a new theory published in the latest issue of the ‘Frontiers of Bioscience’ journal.
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Despite increased use of total hip arthroplasty (THA) and total knee arthroplasty (TKA), there is a notable lack of consensus about optimal postoperative treatment. Aquatic therapy has been shown to have a beneficial effect, and it is typically begun two weeks after surgery, after the wound has healed. According to a new study published in the Archives of Physical Medicine and Rehabilitation, beginning aquatic therapy just 6 days after TKA may lead to improved results, while delaying its onset an additional week may be more appropriate after a THA. Read the rest of this entry »
Monitored by scientists at Kessler Foundation, six people with traumatic spinal cord injuries tested Ekso, the robotic exoskeleton from Ekso Bionics that enables wheelchair users to stand and walk. The six participated in one week of preliminary testing in October 2011. Five patients have paraplegia and one has quadriplegia; they ranged in age from 27 to 45 and had durations of injury from 4 months to 2 years. A video highlights their experiences.
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This simple, yet truly indulgent treat is a snap to make! The dark chocolate and cereal also makes it a wonderfully wholesome snack. Read the rest of this entry »
Researchers in Norway report that patients who receive walking skills training following total hip arthroplasty for osteoarthritis show improved physical function. The physical therapy program displayed a positive effect on walking distance and stair climbing which continued 12 months following hip replacement surgery. Results of the study appear in Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).
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Researchers from the University of Maryland School of Medicine and the Baltimore VA Medical Center have launched a study of exercise and computerized memory training to see if those activities may help people with Parkinson’s disease prevent memory changes. The type of memory that will be examined is known as “executive function;” it allows people to take in information and use it in a new way. Many Parkinson’s patients develop problems with executive function, which can prevent them from working and may eventually require a caregiver to take over more of the complex cognitive tasks of daily living.
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New research published in the journal Science suggests it may be possible to use brain technology to learn to play a piano, reduce mental stress or hit a curve ball with little or no conscious effort. It’s the kind of thing seen in Hollywood’s “Matrix” franchise.
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A 21-yr-old man was being seen for pain and weakness in his right fingers, hand, and forearm for the past 3 mos. Upon detailed questioning, he related that his symptoms ensued after excessive exercise (heavy lift, push-up, pull-up, rope climb, etc) but not during routine daily activities or during rest. The medical history was otherwise noncontributory. Upon physical examination, it was found that there was hyperesthesia/algesia on the dorsal side of the fourth and fifth fingers and the forearm on the right side. Secondary to pain, wrist flexion was limited. Read the rest of this entry »
