Reconsidering the role of attention in optic ataxia: A case report of optic ataxia in visual neglect and extinction

Optic ataxia is a rare condition following dorsal visual stream lesions characterized by peripheral misreaching. This ‘pure’ visuomotor condition is claimed to be dissociable from attentional disorders, such as visual neglect and extinction. However, the relationship between optic ataxia, neglect and extinction is still controversial and recently it has even been suggested these conditions have a common attentional cause. In this single-case report, we investigated 67-year-old female patient E.B. with left visual neglect and extinction following right temporo-parietal and frontal strokes. Unlike most neglect patients, E.B. did not present left hemiparesis or left homonymous hemianopia. This unusual presentation allowed us to study, for the first time, the impact of left visual attentional disorders on reaching with both arms in both free and peripheral vision conditions. Specifically, we assessed whether patient E.B. would present the classic peripheral misreaching deficits reported in patients with optic ataxia. We found that patient E.B.’s reaching accuracy was significantly impaired, when compared to a gender and age-matched control sample (N=11), only in peripheral vision and only for targets presented in her neglected field, regardless of the hand used. Her performance was comparable to controls in free vision for both arms. This demonstrates that a patient with visual neglect and extinction also presents an ataxic field, a deficit typically described as optic ataxia. Our findings suggest that, at least in peripheral vision, attention and visuomotor deficits may be related which challenges long-standing claims of a dissociation between attentional disorders and optic ataxia.

Can cognitive rehabilitation improve attention deficits following stroke? - A Cochrane Review summary with commentary

BACKGROUND: Disorders of attention are common following stroke, reducing quality of life and limiting rehabilitation. OBJECTIVE: To determine if cognitive rehabilitation can improve attention and functional outcomes in stroke survivors with attentional disorders. METHODS: A summary of the Cochrane Review update by Loetscher et al. 2019, with comments. RESULTS: Six studies with 223 participants were included: this was the same as the previous review (in 2013). Evidence quality was very low to moderate, and results suggest a beneficial impact on divided attention immediately after training, but no effect on any other outcome either immediately or at follow up timepoints. CONCLUSIONS: The low methodological quality and small number of studies means current evidence provides limited clinical guidance. Clearly more research is needed to inform care: researchers must improve the methodological quality of studies, plus fully consider and report the aspects of attention and function addressed in their work.

Neurofibromatosis Type 1 with Massive Ventricular Polyposis: First Report in the Medical Literature

BACKGROUND: Neurofibromatosis type 1 (NF1) is a multisystemic disorder with genetic background, characterised by specific cutaneous findings, skeletal dysplasias, and growth of both benign and malignant nervous system tumours. NF1 is caused by mutations in the NF1 gene, situated in chromosome 17q11.2, with an autosomal dominant pattern of inheritance and clinical manifestation of neurofibromas, malignant peripheral nerve sheath tumour, optic and non-optic nerve gliomas, congenital heart disease, cardiovascular and cerebrovascular disease and orthopaedic disorders. The incidence of gastrointestinal manifestations of NF 1 is relatively low, compared to neurological disorders, presenting approximately in 5 to 25% of the patient, but later in life.CASE REPORT: We present a patient with NF1, ventricular polyposis and attentional disorders with cognitive phenotype, while both of her daughters also present with cutaneous manifestations of NF1.CONCLUSION: To the best of our knowledge, this is the first reported case of NF1 with ventricular polyposis as a gastrointestinal manifestation in the mother and NF1 with no signs of inner organ involvement in both of her daughters.

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OBJECTIVES/SPECIFIC AIMS: Attention is a cognitive function that binds perception and behavior. Recent evidence suggests that attention involves phase-amplitude coupling (PAC) of neural signals. PAC occurs when the amplitude of one frequency (frequency for amplitude) is maximal at particular phases of another frequency (frequency for phase). However, some studies suggest PAC improves attention, while others maintain that PAC inhibits attention. The present study seeks to determine whether PAC promotes or inhibits neural signals that underlie attention. METHODS/STUDY POPULATION: Six adult epilepsy patients with implanted electrodes participated in a cued attention task. Subjects participated in a cued attention task where they oriented attention to one side of the screen at a time and discriminated between stimuli as fast as possible with mouse clicks. Perception-related electrodes discriminated the location and/or shape of the target. These were determined with a cluster-based permutation test. Behavior-related electrodes predicted reaction time (RT) with neural activity prior to target appearance. These were determined with correlations between PAC and RT. PAC was calculated using the modulation index (MI). RESULTS/ANTICIPATED RESULTS: We found 47 perception-related electrodes that discriminated location and/or shape of target (p<0.05, FDR corrected). We found 27 behavior-related electrodes where PAC prior to the target predicted RT (p<0.05 FDR corrected). There was little overlap between the perception-related and behavior-related electrodes (3%). PAC also did not discriminate left-sided and right-sided cues. In addition, behavior-related electrodes had less local neural activity and higher PAC during the period of cued attention than perception-related electrodes. DISCUSSION/SIGNIFICANCE OF IMPACT: PAC minimally facilitates perceptual aspect of visual attention. However, PAC facilitate response speed. We suggest that PAC might improve response speed by “quieting” task irrelevant neural activity. For the same reason, PAC is absent in electrodes that are actively processing meaningful streams of visual data. These findings highlight separable aspects of the human attention system and how PAC contributes to both. Future directions include determining differences in PAC for attentional disorders like ADHD and neurological neglect.

Alexitimia como predictor directo y mediado por la depresión en la violencia de pareja / Response to Special Educational Needs and Teaching Efforts in Elementary School

<p>La investigación de la violencia de pareja se ha centrado tradicionalmente en la mujer como víctima y el hombre como agresor; no obstante, la violencia frecuentemente es recíproca. La alexitimia constituye un potencial factor de riesgo de violencia de pareja por sus características de un vínculo inseguro, un estilo pasivo de afrontamiento, un déficit de empatía y dificultades de control emocional. Además, la alexitimia se encuentra relacionada con la depresión. El artículo estudia la relación de la alexitimia con la violencia sufrida y la violencia ejercida (frecuencia y daño) en hombres y mujeres con una pareja heterosexual controlada por la variable depresión. Se aplicaron el Cuestionario de Violencia Sufrida y Ejercida de Pareja (CVSE, Moral de la Rubia &amp; Ramos Basurto, 2015), la Escala de Alexitimia de Toronto de 20 ítems (EAT-20, Bagby, Parker &amp; Taylor, 1994, en su versión mexicana de Moral de la Rubia, 2008a) y el Inventario de Depresión de Beck (2ª ed., IDB-2, Beck, Steer &amp; Brown, 1996, en su Formato Simplificado de Aplicación, IDB-2-FSA; Moral de la Rubia, 2013) a una muestra no probabilística de 240 participantes (120 mujeres y 120 hombres) en Monterrey, México. La alexitimia correlacionó más con la violencia sufrida que con la violencia ejercida, más con el daño que con la frecuencia dentro de la violencia sufrida y más con la frecuencia que con el daño dentro de la violencia ejercida. La mayoría de estas correlaciones permanecieron significativas al parcializar la depresión. En un modelo con buen ajuste en la muestra conjunta (hombres y mujeres), la alexitimia mostró un efecto significativo tanto sobre la violencia sufrida como la ejercida y este efecto fue tanto directo como indirecto con la mediación de la depresión. Concluye que la alexitimia es principalmente un factor de riesgo para sufrir violencia y en menor medida para ejercerla.</p><p> </p><p>Abstract:</p><p><span>According to the Costa Rican Law on Equal Opportunities for Disabled Persons (Igualdad de oportunidades para las personas con discapacidad, Ley N.º 7600), teachers must receive and attend individuals with Special Educational Needs (SEN) inside their regular classrooms applying different curricular modifications. Thus, knowing the amount and types of SEN attended by teachers, and the areas in which they need to improve their teaching skills, will allow considerable improvement for the quality and efficiency of the teachers’ professional training processes for SEN attention. To gather this information, interviews were carried out with fifteen first to sixth grade primary school teachers in a private elementary school in Moravia, Costa Rica. Results make evident that the main SEN attended were attentional disorders and emotional problems. The main limitations facing teachers are lack of time and poor parental support. The areas in which teachers indicated they need training were related to curricular modifications and specific methodologies for SEN. This research is useful for teacher training and Educational Psychology.</span></p>