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prism stroke

Gregory F Guzauskas, Er Chen, Deepa Lalla, Elaine Yu, Darren Tayama, David L Veenstra
Background The Phase IIIb, Double-Blind, Multicenter Study to Evaluate the Efficacy and Safety of Alteplase in Patients With Mild Stroke: Rapidly Improving Symptoms and Minor Neurologic Deficits (PRISMS) trial will assess r-tPA in ischemic stroke patients who present with mild deficits (i.e. mild stroke). Aims To assess PRISMS's societal value in clarifying the optimal care for patients with mild ischemic stroke. Methods A value of information (VOI) decision model was developed to compare the outcomes of mild stroke patients treated vs...
February 2017: International Journal of Stroke: Official Journal of the International Stroke Society
Janet H Bultitude, Alessandro Farnè, Romeo Salemme, Danielle Ibarrola, Christian Urquizar, Jacinta O'Shea, Jacques Luauté
Prism adaptation induces rapid recalibration of visuomotor coordination. The neural mechanisms of prism adaptation have come under scrutiny since the observations that the technique can alleviate hemispatial neglect following stroke, and can alter spatial cognition in healthy controls. Relative to non-imaging behavioral studies, fMRI investigations of prism adaptation face several challenges arising from the confined physical environment of the scanner and the supine position of the participants. Any researcher who wishes to administer prism adaptation in an fMRI environment must adjust their procedures enough to enable the experiment to be performed, but not so much that the behavioral task departs too much from true prism adaptation...
December 30, 2016: Behavior Research Methods
F J Rowe, E J Conroy, E Bedson, E Cwiklinski, A Drummond, M García-Fiñana, C Howard, A Pollock, T Shipman, C Dodridge, C MacIntosh, S Johnson, C Noonan, G Barton, C Sackley
OBJECTIVE: Pilot trial to compare prism therapy and visual search training, for homonymous hemianopia, to standard care (information only). METHODS: Prospective, multicentre, parallel, single-blind, three-arm RCT across fifteen UK acute stroke units. PARTICIPANTS: Stroke survivors with homonymous hemianopia. INTERVENTIONS: Arm a (Fresnel prisms) for minimum 2 hours, 5 days per week over 6 weeks. Arm b (visual search training) for minimum 30 minutes, 5 days per week over 6 weeks...
December 27, 2016: Acta Neurologica Scandinavica
A F Ten Brink, T C W Nijboer, J M A Visser-Meily
- Neglect occurs in 30-50% of patients in the subacute phase post-stroke. Patients with neglect ignore one side of their body or one part of the space around them. - Treatment of neglect is important, as patients with neglect recover more slowly and are less independent compared to patients without neglect.- Visual scanning training is currently recommended in the guidelines as a treatment. The focus of this intensive treatment is on compensation, not on recovery. Scientific evidence for its effectiveness is scarce...
2016: Nederlands Tijdschrift Voor Geneeskunde
Fiona J Rowe, Elizabeth J Conroy, P Graham Barton, Emma Bedson, Emma Cwiklinski, Caroline Dodridge, Avril Drummond, Marta Garcia-Finana, Claire Howard, Stevie Johnson, Claire MacIntosh, Carmel P Noonan, Alex Pollock, Janet Rockliffe, Catherine M Sackley, Tracey Shipman
The authors report the screening process and recruitment figures for the VISION (Visual Impairment in Stroke; Intervention Or Not) trial. This is a prospective, randomised, single-blinded, three-arm controlled trial in 14 UK acute hospital stroke units. Stroke teams identified stroke survivors suspected as having homonymous hemianopia. Interventions included Fresnel prisms versus visual search training versus standard care (information only). Primary outcome was change in visual field assessment from baseline to 26 weeks...
February 2016: Neuro-ophthalmology
Flora M Hammond, David N Alexander, Andrew J Cutler, Stephen D'Amico, Rachelle S Doody, William Sauve, Richard D Zorowitz, Charles S Davis, Paul Shin, Fred Ledon, Charles Yonan, Andrea E Formella, Joao Siffert
No abstract text is available yet for this article.
2016: BMC Neurology
Nathalie Vaes, Gudrun Nys, Christophe Lafosse, Lutgart Dereymaeker, Kristine Oostra, Dimitri Hemelsoet, Guy Vingerhoets
Closely examining the effects, optimal regime and time window of prism adaptation (PA) promotes guidelines for effective rehabilitation practice. The effects of short-term repetitive PA on spatial neglect manifestations were evaluated in patients with heterogeneous post-stroke delays, using a digital Visuospatial Neglect Test Battery. Subsequently, potential differences in PA effects between acute, subacute or chronic neglect were explored. A multicentre randomised controlled trial was conducted in 43 right-hemisphere neglect patients...
July 18, 2016: Neuropsychological Rehabilitation
Joris A Elshout, Freekje van Asten, Carel B Hoyng, Douwe P Bergsma, Albert V van den Berg
The treatment of patients suffering from cerebral blindness following stroke is a topic of much recent interest. Several types of treatment are under investigation, such as substitution with prisms and compensation training of saccades. A third approach, aimed at vision restitution is controversial, as a proper controlled study design is missing. In the current study, 27 chronic stroke patients with homonymous visual field defects were trained at home with a visual training device. We used a discrimination task for two types of stimuli: a static point stimulus and a new optic flow-discontinuity stimulus...
2016: Frontiers in Neurology
Flora M Hammond, David N Alexander, Andrew J Cutler, Stephen D'Amico, Rachelle S Doody, William Sauve, Richard D Zorowitz, Charles S Davis, Paul Shin, Fred Ledon, Charles Yonan, Andrea E Formella, Joao Siffert
BACKGROUND: Phase 3 trials supporting dextromethorphan/quinidine (DM/Q) use as a treatment for pseudobulbar affect (PBA) were conducted in patients with amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS). The PRISM II study provides additional DM/Q experience with PBA secondary to dementia, stroke, or traumatic brain injury (TBI). METHODS: Participants in this open-label, multicenter, 90-day trial received DM/Q 20/10 mg twice daily. The primary outcome was the Center for Neurologic Study-Lability Scale (CNS-LS), assessing change in PBA episode frequency and severity...
June 9, 2016: BMC Neurology
Se-Il Oh, Jin-Kyung Kim, So-Yeon Park
[Purpose] This study aimed to examine the effects of visual field with prism glasses, and intensive upper limb functional training on reduction of hemineglect and improvement in upper limb function and activities of daily living in three stroke patients with hemineglect. [Subjects] This study included three stroke patients hospitalized in a sanatorium. [Methods] Intervention treatment involving prism glass use for 12 hours and 30 minutes and paretic side upper limb training was conducted 5 days a week for 15 weeks...
December 2015: Journal of Physical Therapy Science
Nuria Lacuey, Bilal Zonjy, Wanchat Theerannaew, Kenneth A Loparo, Curtis Tatsuoka, Jayakumar Sahadevan, Samden D Lhatoo
We analyzed the only two sudden unexpected death in epilepsy (SUDEP) cases from 320 prospectively recruited patients in the three-year Prevention and Risk Identification of SUDEP Mortality (PRISM) project. Both patients had surgically refractory epilepsy, evidence of left insular damage following previous temporal/temporo-insular resections, and progressive changes in heart rate variability (HRV) in monitored evaluations prior to death. Insular damage is known to cause autonomic dysfunction and increased mortality in acute stroke...
February 2016: Epilepsy & Behavior: E&B
Rachelle S Doody, Stephen D'Amico, Andrew J Cutler, Charles S Davis, Paul Shin, Fred Ledon, Charles Yonan, João Siffert
BACKGROUND: Dextromethorphan (DM)/quinidine (Q) is an approved treatment for pseudobulbar affect (PBA) based on trials in amyotrophic lateral sclerosis or multiple sclerosis. PRISM II evaluated DM/Q effectiveness and tolerability for PBA secondary to dementia, stroke, or traumatic brain injury; dementia cohort results are reported. METHODS: This was an open-label, multicenter, 90 day trial; patients received DM/Q 20/10 mg twice daily. Primary outcome was change in Center for Neurologic Study-Lability Scale (CNS-LS) score...
December 2016: CNS Spectrums
Inmaculada Riquelme, Camille Henne, Benoit Flament, Valéry Legrain, Yannick Bleyenheuft, Samar M Hatem
INTRODUCTION: Unilateral visuospatial deficits have been observed in children with brain damage. While the effectiveness of prism adaptation for treating unilateral neglect in adult stroke patients has been demonstrated previously, the usefulness of prism adaptation in a pediatric population is still unknown. The present study aims at evaluating the feasibility of prism adaptation in children with unilateral brain lesion and comparing the validity of a game procedure designed for child-friendly paediatric intervention, with the ecological task used for prism adaptation in adult patients...
August 2015: Research in Developmental Disabilities
Stephane J MacLean, Cameron D Hassall, Yoko Ishigami, Olav E Krigolson, Gail A Eskes
Prism adaptation (PA) is both a perceptual-motor learning task as well as a promising rehabilitation tool for visuo-spatial neglect (VSN)-a spatial attention disorder often experienced after stroke resulting in slowed and/or inaccurate motor responses to contralesional targets. During PA, individuals are exposed to prism-induced shifts of the visual-field while performing a visuo-guided reaching task. After adaptation, with goggles removed, visuomotor responding is shifted to the opposite direction of that initially induced by the prisms...
2015: Frontiers in Human Neuroscience
Pooja Khatri, Darren Tayama, Geoff Cohen, Richard I Lindley, Joanna M Wardlaw, Sharon D Yeatts, Joseph P Broderick, Peter Sandercock
BACKGROUND AND PURPOSE: Randomized trial evidence on the risk/benefit ratio of thrombolysis for mild stroke is limited. We sought to determine the efficacy of intravenous recombinant tissue-type plasminogen activator (IV r-tPA) in a subset of patients with mild deficit in the third International Stroke Trial (IST-3). METHODS: IST-3 compared IV r-tPA with control within 6 hours of onset in patients for whom IV r-tPA was considered promising but unproven. Analysis was restricted to subjects randomized within 3 hours of onset with a baseline National Institutes of Health Stroke Scale ≤5, pretreatment blood pressure <185/110, and no other r-tPA exclusion criteria...
August 2015: Stroke; a Journal of Cerebral Circulation
Kelly M Goedert, Jeffrey Y Zhang, A M Barrett
Spatial neglect is a devastating disorder in 50-70% of right-brain stroke survivors, who have problems attending to, or making movements towards, left-sided stimuli, and experience a high risk of chronic dependence. Prism adaptation is a promising treatment for neglect that involves brief, daily visuo-motor training sessions while wearing optical prisms. Its benefits extend to functional behaviors such as dressing, with effects lasting 6 months or longer. Because one to two sessions of prism adaptation induce adaptive changes in both spatial-motor behavior (Fortis et al...
2015: Frontiers in Human Neuroscience
Shih-Chi Chen, Heejin Choi, Peter T C So, Martin L Culpepper
This paper presents the design and characterization of a three-axis thermomechanical actuator-based endoscopic scanner for obtaining ex vivo two-photon images. The scanner consisted of two sub-systems: 1) an optical system (prism, gradient index lens, and optical fiber) that was used to deliver and collect light during imaging and 2) a small-scale silicon electromechanical scanner that could raster scan the focal point of the optics through a specimen. The scanner can be housed within a 7 mm Ø endoscope port and can scan at the speed of 3 kHz × 100 Hz × 30 Hz along three axes throughout a 125 × 125 × 100 μm(3) volume...
May 29, 2014: Journal of Microelectromechanical Systems
Antonia F Ten Brink, Johanna M A Visser-Meily, Tanja C W Nijboer
BACKGROUND: A frequent disorder after stroke is neglect, resulting in a failure to report or respond to contralesional stimuli. Rehabilitation of neglect is important, given the negative influence on motor recovery, independence in self-care, transfers, and locomotion. Effects of prism adaptation (PA) to alleviate neglect have been reported. However, either small groups or no control group were included and few studies reported outcome measurements on the level of activities of daily living (ADL)...
February 4, 2015: BMC Neurology
Wenle Zhao, Yunming Mu, Darren Tayama, Sharon D Yeatts
Large multicenter acute stroke trials demand a randomization procedure with a high level of treatment allocation randomness, an effective control on overall and within-site imbalances, and a minimized time delay of study treatment caused by the randomization procedure. Driven by the randomization algorithm design of A Study of the Efficacy and Safety of Activase (Alteplase) in Patients with Mild Stroke (PRISMS) (NCT02072226), this paper compares operational and statistical properties of different randomization algorithms in local, central, and step-forward randomization settings...
March 2015: Contemporary Clinical Trials
G Rode, S Lacour, S Jacquin-Courtois, L Pisella, C Michel, P Revol, N Alahyane, J Luauté, S Gallagher, P Halligan, D Pélisson, Y Rossetti
Spatial neglect (SN) is commonly associated with poor functional outcome. Adaptation to a rightward optical deviation of vision has been shown to benefit to SN rehabilitation. The neurophysiological foundations and the optimal modalities of prism adaptation (PA) therapy however remain to be validated. This study is aimed at exploring the long-term sensory-motor, cognitive and functional effects produced by weekly PA sessions over a period of four weeks. A double-blind, monocentric randomized and controlled trial (RCT) was carried out...
April 2015: Annals of Physical and Rehabilitation Medicine
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