Unilateral spatial neglect is an important factor for affecting the brain damage,especially in patients with functional recovery after stroke.Seeking for the effective rehabilitation measles of unilateral spatial neglect has an important significance for improving the quality of life in patients.Currently,prism adaptation is the most widely used and well-studied treatment for unilateral spatial neglect,however,there is less domestic research in this field.This article reviews the advances in research on the therapeutic mechanism of prism adaptation for unilateral spatial neglect,the application in unilateral spatial neglect after stroke as well as its efficacy.

Hemispatial neglect often occurs after brain injury, especially the higher incidence after stroke. The studies on cognition, attention, and perception have greater significance. However, the related domestic studies at present are rare. Being themed by line bisection, this article reviews the influencing factors and relevant mechanisms, brain location, and extensional study in the assessment of hemispatial neglect.

ObjectiveTo investigate the effect of expressional chimeric faces on the attentional bias in unilateral spatial neglect (USN) patients.Methods12 USN patients and 30 matched healthy controls (HC) were involved in this study.All of them were performed with happy-neutral and sad-neutral expressional chimeric faces (ECF) and the attentional deviation scores were compared between and within groups.ResultsThere were statistically significant differences of attentional deviation scores ( happy-neutral ECF:t =15.550,P ＜ 0.0l ; sadneutral ECF:t=12.192,P＜0.01 ) between the USN group (happy-neutral ECF:0.78 ±0.22;sad-neutral ECF:0.50 ±0.20) and the HC group (happy-neutral ECF:-0.31 ±0.20;sad-neutral ECF:-0.25 ±0.17),with rightward bias in the USN group and small leftward bias in the HC group.For the USN group,the magnitude of rightward bias in the sad-neutral ECF condition was reduced than in the happy-neutral ECF condition ( t =3.954,P=0.002 ).There were no statistically differences under happy-and sad-neutral ECF conditions within the HC group ( t =- 1.302,P =0.203 ).ConclusionsUSN patients show rightward attentional bias under both happyand sad-neutral ECF conditions.However,the magnitude of rightward bias under the sad-neutral ECF condition are reduced significantly.This might be attributed to the unconscious processing of stimuli in the neglected side and emotion cognition of the brain hemispheres.

Objective To investigate the relationship of attentional orientation,sensory disorder or magnitude estimation with cross-over effect in the line bisection of hemispatial neglect patients and to evaluate the influences of the length of lines and cueing on the performance of line bisection of neglect patients.Methods Fifteen patients with hemispatial neglect and 15 age and education-level-matched healthy controls underwent line bisection experiment.in which difierent types of cues and difierent length of bisected lines were given to observe their effects on the deviation.Analyses of variance (ANOVAs)were used to analyze the data in each group.Results When the lengths of lines were 4,6,8,10,12 cm,percentages of line bisection deviation(%)without cue were-5.71±5.13,-2.48±8.83,-1.18±10.90.0.43±8.12,2.17±7.04 respectively.The experiment showed that deviation was related to the length of lines ( F=12.5,P＜0.01).Nine patients exhibited cross-over effect when the lines were shorter than 10 cm.Another interesting result was that ipsilesional cues led to a reduction in bisection errors ( percentages of line bisection deviation(%)were-3.93±7.04,2.43±6.34,4.93±5.19,6.49±3.36,6.38±4.18,P＜0.01),however,contralesional ones resulted in a reverse effect(percentages of bisection deviation(%)were-10.93±8.85,-7.95±8.44,-4.14±8.37,-2.60±9.96,-1.57±10.67,P=0.03).As for bilateral cues,both cueing had no influence on line bisection(percentages of bisection deviation(%)were -5.93±7.76,-0.52±8.20,0.54±6.34.2.57±5.02,2.79±3.92,P=0.35).The length of cues had no influence on line bisection(F=1.94.P=0.1 4).Condusions The subjective midpoint excurses toward left when the length of line is relatively short.which is referred as crossover effect.indicating magnitude estimation a factor of crossover effect.Unilateral cues affects the performance of line dissection of neglect patients.which may be accounted for attentional orientational biases.No effect of the cue length suggested sensory disorder does not play a role in the crossover effect.

Objective To investigate the characteristics and plausible mechanisms of attention network impairments in hyperthyroid patients.Methods 34 hypertyroid patients and 33 normal controls performed the attention network test (ANT),which was used for assessing three components of attentional networks including alerting,orienting,and executive control.Results The mean scores for alerting and orienting networks were significantly shorter (P ＜ 0.01) in hyperthyroid patients (respectively,(20.00 ± 22.47) ms,(35.26 ± 22.65) ms)than those in normal controls (respectively,(35.70 ± 17.62) ms,(50.61 ± 23.66) ms).The mean reaction time for executive control network was significantly longer(P ＜ 0.01) in hyperthyroid patients((116.71 ± 40.36)ms)than those in controls ((93.00 ± 29.34)ms).Triiodothyronine(T3) and thyroxine(T4) were positively correlated with the scores for executive control network (respectively,r=0.350,P＜ 0.05; r=0.417,P＜ 0.05) in hyperthyroid patients,whereas no relationship was found between thyroid stimulating hormone(TSH) and the value of executive control network.T3,T4 and TSH were not correlated with the value of alerting and orienting network in hyperthyroid patients.Conclusion Hypertyroid patients have extensive impairments in various kinds of attentional network,rather than a specific deficit.The recession of executive control network accompanies with enhancement of serum levels of T3,T4 in hyperthyroid patients.

Objective To explore neglect dyslexia in unilateral spatial neglect patients,the error type and whether there exists word length and semantic effect.Methods Ten left spatial neglect patients were investigated by Chinese characters reading material.Results Unilateral spatial patients showed neglect dyslexia (202 neglect errors,94.0％ of the total 215 errors) when reading.The most common errors were omissions (148 errors,73.3％ of the total 202 neglect errors),followed by substitutions and additions.The error rate of two words was 9.9％ ± 8.4％,while the rate of three words was 18.8％ ± 16.2％.Performance was worse with the increase of word length (T =-55,P ＜ 0.05).The error rate of words was 8.3％ ± 7.5％,while the rate of non-words was 18.9％ ± 16.6％,and the rate of non-words was worse than that of words (T =-55,P ＜ 0.05).Conclusions Our study has shown that omissions are the most common error type of neglect dyslexia in Chinese unilateral spatial neglect patients,and the impairment include word length effect.The patients with unilateral spatial neglect show preserved semantic processing in the neglect side.

Objective To investigate the existence of neglect and explore the relationship between spacial attentional deficits and hemisphere in patients with schizophrenia. Methods 51 schizophrenic patients and 55 healthy controls were measured with line bisection test and number bisection test、 Results In the Line Bisection Test,shcizophrenic patients group showed a negative deviation, in which the 2cm line( -0.03 ± 0. 74 )% and mean ( - 0. 02 ± 0. 03 ) % deviation rates were more significantly leftward than that of the normals ( ( 0. 00 ±0.02 ) %, ( - 0.00 ± - 0.01 ) %, P ＜ 0. 05 ) respectively. The mean deviation rates of the patients (P ＜ 0. 01 ) and control groups (P ＜ 0. 05 ) were also significantly leftward compared with zero value. In the number bisection test,schizophrenic patients group showed a negative deviation and a significant leftward bias on the interval 5 ( - 0.07 ±0.18)% ,7( -0.08 ±0.22)% and 9( -0.09 ±0.28)% ) than that of the normals(( -0.01 ±0.05)% ,(0.01± 0. 08 ) % and (0.00 ± 0.14 ) %, P ＜ 0.05 respectively). Conclusion Schizophrenic patients have a right-neglect, suggesting that spacial attentional deficits exist, and it may be related to the left cerebral hemisphere dysfunction.

Objective To observe microstructural changes of white matter in Alzheimer's disease (AD),and to find out the relationship between white matters lesion and declined cognition.Methods Twenty-four AD patients and 24 controls with normal cognition performed diffusion tensor imaging MR scan.Tract-based spatial statistical analysis (TBSS) was used to investigate microstructural change of white matter,and then its correlation with Mini-Mental State Examination (MMSE) scores was analyzed.Results Fractional anisotropy (FA) values were decreased in corpus callosum,fornix,left corticospinal tract,bilateral cerebral peduncle,superior cerebellar peduncle,internal capsule,corona radiata,posterior thalamic radiation,sagittal stratum including inferior longitidinal fasciculus and inferior fronto-occipital fasciculus,external capsule,cingulate gyrns,hippocampus,superior longitudinal fasciculus and uncinate fasciculus,while mean diffusivity (MD) values were increased in fornix,left hippocampus,bilateral internal capsule,corona radiata,posterior thalamic radiation,sagittal stratum including inferior longitidinal fasciculus and inferior fronto-occipital fasciculus,external capsule,cingulate gyrus,superior longitudinal fasciculus,superior fronto-occipital fasciculus and uncinate fasciculus (all P ＜ 0.05,threshold-free cluster enhancement corrected).MMSE scores had a positive correlation with decreased FA values of left sagittal stratum (r =0.535,P =0.007) and negative correlations with increased MD values of left sagittal stratum (r =-0.427,P =0.037),left superior longitudinal fasciculus (r =-0.424,P =0.039) and left uncinate fasciculus (r =-0.505,P =0.012).Conclusions There exist widespread white matter lesions in AD with impairment of white matter connections of intra-and inter-hemispheres.Impaired white matters in left hemisphere may have close relationships with cognition decline.

Objective To explore the biological motion perception in Parkinson's disease (PD).Methods 45 individuals with idiopathic PD were compared with 45 matched healthy controls (HCs) using a duration discrimination task.Results The point of subjective equality(PSE) was negative value (-0.27±0.17) for health controls (HCs),and there was significant difference compared with PSE =0 by one sample t test (t=10.96,P＜ 0.01).Compared with HCs,the PSE for PD patients (-0.14±0.30) significantly decreased (t=2.63,P=0.01).When further dividing PD into early stages (stage 1-2) and late stages (stage 3-4),significant difference was found between late-stage PD patients(0.02±0.39)and HCs (t=4.07,P=0.008),but not between early-stage PD patients (-0.24±0.14) and HCs (t=0.84,P=0.405).Conclusion There is biological motion perception disorder in PD patients and it is related to the severity of PD.

OBJECTIVE: To investigate the neuroprotective effects of Ginkgolide B (GB) against ischemic stroke-induced injury in vivo and in vitro, and further explore the possible mechanisms concerned. METHODS: Transient middle cerebral artery occlusion (tMCAO) mice and oxygen-glucose deprivation/reoxygenation (OGD/R)-treated N2a cells were used to explore the neuroprotective effects of GB. The expression of brain-derived neurotrophic factor (BDNF) was detected via Western blot and qRT-PCR. RESULTS: GB treatment (4 mg/kg, i. p., bid) significantly reduced neurological deficits, water content, and cerebral infarct volume in tMCAO mice. GB also significantly increased Bcl-2/Bax ratio, reduced the expression of caspase-3, and protected against OGD/R-induced neuronal apoptosis. Meanwhile, GB caused the up-regulation of BDNF protein in vivo and in vitro. CONCLUSION: Our data suggest that GB might protect the brain against ischemic insult partly via modulating BDNF expression.
Animals ; Apoptosis ; Blotting, Western ; Brain ; Brain-Derived Neurotrophic Factor* ; Caspase 3 ; In Vitro Techniques ; Infarction, Middle Cerebral Artery ; Mice ; Neurons ; Neuroprotective Agents ; Stroke* ; Up-Regulation ; Water