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Transcranial direct current stimulation (tDCS) is a novel brain stimulation technique which has kindled hope in alleviating motor, language as well as cognitive deficits in neuronal injury. Current case report describes application of tDCS in two phases using two different protocols in a patient with hypoxic injury. In the first phase anodal stimulation of dorsolateral prefrontal cortex improved the language fluency. Subsequently, after 6 months second phase application of anodal stimulation over posterior parietal region targeted arithmetic and working memory deficits. Individualising the treatment protocols of brain stimulation, based on the lesion and the functional deficits, for neuro-rehabilitation is emphasised.
Subject(s)
Humans , Brain , Clinical Protocols , Cognition Disorders , Dyscalculia , Hope , Hypoxia-Ischemia, Brain , Memory, Short-Term , Neurons , Parietal Lobe , Prefrontal Cortex , Rehabilitation , Transcranial Direct Current StimulationABSTRACT
El síndrome de Gerstmann es una rara enfermedad neurológica de causa vascular que afecta al lóbulo parietal. Se reporta el caso de un paciente masculino de 63 años con antecedentes patológicos personales de miocardiopatía dilatada. El 24 de enero de 2016 en horas de la mañana presentó de forma súbita pérdida de la conciencia con caída al suelo. Después de recuperarse tuvo estado confusional, desorientación topográfica de breve duración y dificultad para la expresión del lenguaje y la nominación de los objetos, por esta causa se decide su ingreso, durante el cual se realiza resonancia magnética simple de cráneo donde se observó imagen hipointensa en FLAIR en región parietal izquierda compatible con lesión isquémica. Se efectuó evaluación neuropsicológica encontrándose: agnosia digital, agrafia, acalculia y confusión derecha-izquierda. Se diagnostica un síndrome de Gerstmann completo(AU)
Gerstmann syndrome is a rare neurological disease of vascular cause that affects the parietal lobe. The case is reported of a 63-year-old male patient with a personal pathological history of dilated cardiomyopathy. In the morning of January 24, 2016, the patient presented sudden loss of consciousness with a fall to the ground. After recovering, he experienced a confusion state, short-lived topographical disorientation, and difficulty in expressing language and the naming of objects, a reason why his admittance was decided. During the admittance, simple magnetic resonance imaging to the skull was performed, which permitted to observe a hypo-intense image in FLAIR in the left parietal region and that was compatible with an ischemic lesion. A neuropsychological evaluation was performed: digital agnosia, agraphia, acalculia and confusion regarding right or left. A whole Gerstmann syndrome was diagnosed.(AU)
Subject(s)
Humans , Male , Aged , Gerstmann Syndrome/history , Gerstmann Syndrome/epidemiology , Case ReportsABSTRACT
Objective To investigate errors and the mechanism of acalculia in patients with left or right hemisphere cerebral infarction.Methods Fifty-six patients with single hemisphere cerebral infarction and 56 normal adults who were matched in age,sex and years of education were tested with EC301-CR.The patients were divided into a left hemisphere cerebral infarction group(n =34)and a right hemisphere cerebral infarction group(n =22).Results The scores on 30 out of 32 EC301-CR items were significantly lower among the patients than in the normal control group.Scores on 14 EC301-CR items were significantly lower in the left hemisphere group than in the right hemisphere group.In the left hemisphere group the item scores of aphasia patients were significantly lower than those of no-aphasia patients except on digit identity.Conclusion Mathematical processing and calculation were impaired in patients with single hemisphere cerebral infarction.Calculation was significantly worse among left hemisphere patients compared with right hemisphere cerebral infarction.There was a highly significant correlation between acalculia and aphasia.
ABSTRACT
@#The behavioral performance and mechanism of spatial acalculia were reviewed in this paper. Meanwhile, the brain mechanism and cognitive impairment are also preliminarily introduced.
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@#Objective To compare the efficacy of different rehabilitation models on acalculia after acquired brain injury. Methods 113 cases were randomly assigned to 3 groups: control group(n=37), computer-assisted training group(n=38) and face-to-face training group(n=38). The control group just received cognitive dysfunction evaluation. The training groups received cognitive rehabilitation training 5 days a week and 30 minutes a day which sustained for 6 weeks. And 33 patients were selected to prolong for 12 weeks. They were evaluated with Revised EC301Calculation and Number Processing Battery in Chinese version (EC301-CR) at the beginning, the 6th week point and the 12th week point respectively. Results 6-week after treatment, The performance of both the computer-assisted training group and face-to-face training group significantly improved(P<0.001); It showed that computer-assisted group>face-to-face group>control group(P<0.001) both 6 weeks and 12 weeks latter. Significant negative correlation was found between age and performance of EC301-CR(P<0.05).Conclusion The effect of computer-assisted training on acalculia is superior to face-to-face training; The first 6 weeks of training is the best period for rehabilitation; The younger the patient is, the better results are.
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@#Objective To analyze the reliability and validity of Revised EC301Calculation and Number Processing Battery in Chinese version (EC301-CR); To establish diagnostic criteria by EC301-CR for acalculia in order to provide an effective assessment tool clinically. Methods The items of EC301were adjusted. 103 patients with acquired brain injury and 37 normal controls were randomly selected. 24 normal controls randomly selected were retested 6 weeks latter. Results The Cronbach's coefficient, the split-half reliability and the retest reliability coefficients were 0.907, 0.744, and 0.965, respectively. The correlation coefficient within subscales was more than the correlation coefficient between subscales. 4 first-order factors were extracted which accounted for 69.359% of the accumulated variance, which were mental calculation, number transcoding, written calculation and approximation, and understanding of numbers. Control data (n=37) showed that the P10 of EC301-CR was 222.6. Conclusion The critical value of acalculia is 222.6 in EC301-CR test. Psychometric properties analysis shows that EC301-CR is a reliable and validated instrument for acalculia.
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@#Acalculia has been defined as an acquired disturbance in number processing and computational ability. Acalculia which caused by various diseases has a great effect on activity of daily living. This article presents a review of Standardized Tests of Acalculia(including EC301 calculation and number processing battery, Number Processing and Calculation battery and Johns Hopkins Dyscalculia Battery) and cognitive rehabilitation for acalculia. The main strategy for rehabilitation is to re-teach lost knowledge via extensive practice according to the evaluative results. Those are described in 5 domains: the understanding of numbers, number transcoding, arithmetical facts, complex calculation and mathematics applications.
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BACKGROUND: From a neuropsychological point of view calculation is a very complex function. A simple arithmetic operation demands many neurocognitive mechanisms that involve verbal, spatial and graphical processing, memory and attention. OBJECTIVE: To verify the calculation and number processing of healthy subjects and the effect of gender, age and schooling on their performance. METHOD: Forty-four normal subjects without complaints or neurological changes were evaluated. RESULTS: The educational level was significantly linked to performance in the majority of tests of the EC 301 battery, whereas no differences were noted regarding age and gender. CONCLUSION: Evaluation of the data of the healthy population shown in this study indicated that educational level can affect calculation and number processing, It is possible to note that battery EC 301 demonstrated sensitivity for appraisal of these abilities and therefore can be employed for clinical assessment in calculation and number disorders.
INTRODUÇÃO: O cálculo do ponto de vista neuropsicológico é uma função muito complexa. Em uma simples operação aritmética estão envolvidos diversos processos neurocognitivos que envolvem os processamentos verbais, espaciais, gráficos, atenção e memória. OBJETIVO: Este estudo teve por objetivo verificar o desempenho de indivíduos saudáveis, no processamento numérico e de cálculo, através da bateria EC 301 e verificar as interferências do sexo, da idade e da escolaridade no desempenho destes indivíduos. MÉTODO: Foram avaliados 44 sujeitos normais sem queixas e/ou alterações neurológicas. RESULTADOS: O nível educacional mostrou-se fortemente relacionado ao desempenho obtido na maioria das provas da bateria EC 301, enquanto em relação ao sexo e idade não foram encontradas diferenças. CONCLUSÃO: Os dados encontrados na população avaliada neste estudo mostraram que o nível educacional pode influenciar o desempenho do processamento numérico e de cálculo, sendo possível observar que a bateria EC 301 mostrou-se sensível para avaliar estas habilidades, podendo assim ser utilizada na avaliação clínica dos distúrbios numéricos e de cálculo.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Mental Processes/physiology , Neuropsychological Tests , Problem Solving/physiology , Age Factors , Brazil , Educational Status , Mathematics , Pilot Projects , Reference Values , Young AdultABSTRACT
@#Objective To investigate errors and mechanism of acalculia in patients with brain injury.Methods Forty patients with brain injury and forty-eight normal adults who were matched in age and years of education were tested with EC301 standardized battery. Patients were divided into the left-brain damaged (LBD) group (n=20), right-brain damaged (RBD) group (n=9) and bilateral brain damaged (BBD) group (n=11). The data of all subjects were statistical analyzed.Results Both total scores and scores of 27 out of 31 items were remarkable lower in patients than those in the normal control group ( P<0.05). The total scores and items' scores for number sequences, numerical transcodings were significantly lower in LBD group than those in RBD group ( P<0.05). Total scores and each items' score did not significantly differ between BBD group and LBD group, or between BBD group and RBD group ( P>0.05).Conclusion The abilities of number processing and calculation are impaired in patients with brain injury. There is either association or dissociation in terms of performance of acalculia and aphasia in LBD patients. Visuospatial impairment is related to performance of acalculia in RBD patients.
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@#Despite the general agreement that calculation ability is an important component of cognition,and a comprehensive cognitive evaluation should include testing for calculation ability,there is a significant paucity in study and evaluation of acalculia.In this paper,the concepts and classification of acalculia are proposed;main neuropsychological theoretical models and cerebral mechanisms are presented;clinical appearances,standard testing instruments and related study of acalculia are intensively reviewed;finally,rehabilitation training of acalculia is initially discussed.