Browsing by Author "Anderson, Britt"
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Item Assessment and recovery of visually guided reaching deficits following cerebellar stroke(2023) Robles, Chella M.; Anderson, Britt; Dukelow, Sean P.; Striemer, ChristopherThe cerebellum is known to play an important role in the coordination and timing of limb movements. The present study focused on how reach kinematics are affected by cerebellar lesions to quantify both the presence of motor impairment, and recovery of motor function over time. In the current study, 12 patients with isolated cerebellar stroke completed clinical measures of cognitive and motor function, as well as a visually guided reaching (VGR) task using the Kinarm exoskeleton at baseline (~2 weeks), as well as 6, 12, and 24-weeks post-stroke. During the VGR task, patients made unassisted reaches with visual feedback from a central ‘start’ position to one of eight targets arranged in a circle. At baseline, 6/12 patients were impaired across several parameters of the VGR task compared to a Kinarm normative sample (n=307), revealing deficits in both feed-forward and feedback control. The only clinical measures that consistently demonstrated impairment were the Purdue Pegboard Task (PPT; 9/12 patients) and the Montreal Cognitive Assessment (6/11 patients). Overall, patients who were impaired at baseline showed significant recovery by the 24-week follow-up for both VGR and the PPT. A lesion overlap analysis indicated that the regions most commonly damaged in 5/12 patients (42% overlap) were lobule IX and Crus II of the right cerebellum. A lesion subtraction analysis comparing patients who were impaired (n=6) vs. unimpaired (n=6) on the VGR task at baseline showed that the region most commonly damaged in impaired patients was lobule VIII of the right cerebellum (40% overlap). Our results lend further support to the notion that the cerebellum is involved in both feedforward and feedback control during reaching, and that cerebellar patients tend to recover relatively quickly overall. In addition, we argue that future research should study the effects of cerebellar damage on visuomotor control from a perception-action theoretical framework to better understand how the cerebellum works with the dorsal stream to control visually guided action.Item Cerebellar lesions disrupt spatial and temporal visual attention(2021) Craig, Brandon T.; Morrill, Adam; Danckert, James; Anderson, Britt; Striemer, ChristopherThe current study represents the first comprehensive examination of spatial, temporal and sustained attention following cerebellar damage. Results indicated that, compared to controls, cerebellar damage resulted in a larger cueing effect at the longest SOA – possibly reflecting a slowed the onset of inhibition of return (IOR) during a reflexive covert attention task, and reduced the ability to detect successive targets during an attentional blink task. However, there was little evidence to support the notion that cerebellar damage disrupted voluntary covert attention or the sustained attention to response task (SART). Lesion overlay data and supplementary voxel-based lesion symptom mapping (VLSM) analyses indicated that impaired performance on the reflexive covert attention and attentional blink tasks were related to damage to Crus II of the left posterior cerebellum. In addition, subsequent analyses indicated our results are not due to either general motor impairments or to damage to the deep cerebellar nuclei. Collectively these data demonstrate, for the first time, that the same cerebellar regions may be involved in both spatial and temporal visual attention.Item Left cerebellar lesions may be associated with an increase in spatial neglect-like symptoms(2023) Verbitsky, Ryan; Anderson, Britt; Danckert, James; Dukelow, Sean; Striemer, ChristopherEach cerebellar hemisphere projects to the contralateral cerebral hemisphere. Previous research suggests a lateralization of cognitive functions in the cerebellum that mirrors the cerebral cortex, with attention/visuospatial functions represented in the left cerebellar hemisphere, and language functions in the right cerebellar hemisphere. Although there is good evidence supporting the role of the right cerebellum with language functions, the evidence supporting the notion that attention and visuospatial functions are left lateralized is less clear. Given that spatial neglect is one of the most common disorders arising from right cortical damage, we reasoned that damage to the left cerebellum would result in increased spatial neglect-like symptoms, without necessarily leading to an official diagnosis of spatial neglect. To examine this disconnection hypothesis, we analyzed neglect screening data (line bisection, cancellation, figure copying) from 20 patients with isolated unilateral cerebellar stroke. Results indicated that left cerebellar patients (n=9) missed significantly more targets on the left side of cancellation tasks compared to a normative sample. No significant effects were observed for right cerebellar patients (n=11). A lesion overlap analysis indicated that Crus II (78% overlap), and lobules VII and IX (66% overlap) were the regions most commonly damaged in left cerebellar patients. Our results are consistent with the notion that the left cerebellum may be important for attention and visuospatial functions. Given the poor prognosis typically associated with neglect, we suggest that screening for neglect symptoms, and visuospatial deficits more generally, may be important for tailoring rehabilitative efforts to help maximize recovery in cerebellar patients.