RESUMO
Unilateral spatial neglect (USN) can have severe functional consequences for patients. Many rehabilitation tools have been proposed in the literature, but only a few well-controlled systematic studies are available. Also, there is no consensus on the effectiveness of these rehabilitation techniques. Yet, left USN is one of the most common neuropsychological symptoms after right hemispheric stroke. This article reviews the main tools available to clinicians, their limitations, and prospects for the development of new rehabilitation options.
La négligence spatiale unilatérale (NSU) est un déficit qui peut avoir de lourdes conséquences fonctionnelles pour les patients qui en sont atteints. De nombreux outils ont été proposés dans la littérature mais peu d'études systématiques bien contrôlées sont disponibles. Aussi, il n'existe pas de consensus dans la littérature à propos de l'efficacité de la rééducation. Pourtant, la NSU gauche est un des symptômes les plus fréquents après un AVC de l'hémisphère droit. Cet article fait le point sur les principaux outils à disposition des cliniciens, leurs limites et les perspectives de développement de nouvelles alternatives de rééducation.
Assuntos
Transtornos da Percepção , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Acidente Vascular Cerebral/complicações , Transtornos da Percepção/etiologia , Transtornos da Percepção/psicologia , Testes NeuropsicológicosRESUMO
BACKGROUND: Embodied models of social cognition argue that others' affective states are processed by re-enacting a sensory-specific representation of the same state in the observer. However, neuroimaging studies suggest that a reliable part of the representation shared between self and others is supramodal and relates to dimensions such as Unpleasantness or arousal, common to qualitatively different experiences. Here we investigated whether representations of first-hand pain and disgust influenced the subsequent evaluation of facial expressions in Modality-specific fashion, or in terms of Unpleasantness or arousal. METHODS: Thirty volunteers were subjected to thermal painful and olfactory disgusting events, and subsequently were asked to classify computer-generated faces expressing pain (characterized by high Unpleasantness and arousal), disgust (high Unpleasantness and low arousal), surprise (low Unpleasantness and high arousal) and hybrid combinations thereof. RESULTS: Thermal and olfactory events were associated with comparable Unpleasantness ratings and heart rate (but stronger galvanic response was found for painful temperatures). Furthermore, we found that the appraisal of facial expressions was biased by the prior stimulus, with more frequent pain classifications following thermal stimuli, and more frequent disgust classifications following olfactory stimuli. Critically, this modulation was cross-modal in nature, as each first-hand stimulation influenced in comparable fashion facial traits diagnostic of both pain and disgust, without instead generalizing to features of surprise. CONCLUSION: Overall, these data support the presence of shared coding between one's aversive experiences and the appraisal of others' facial responses, which is best describable as supramodal representation of the Unpleasantness of the experience. SIGNIFICANCE: These results extend previous findings about common representational coding between the experience of first-hand and others' pain. In particular, they highlight that reliable part of the information shared is supramodal in nature and relates to a broad dimension of Unpleasantness common also to painless aversive states such as disgust.
