Diffusion tensor imaging of the brain in children with sensory processing disorder: A review.

Sensory processing disorder (SPD) is a clinical condition characterized by difficulties in the neurological processes of registering, discriminating, organizing, and responding to various sensory sensations. This study aimed to review the association between impaired white matter (WM) tract structure and neurofunctional deficits in children with SPD using diffusion tensor imaging (DTI). A comprehensive literature search was conducted using the online databases Google Scholar and PubMed (from 2010 to July 2023), resulting in the selection of nine relevant studies. Findings revealed that the splenium of the corpus callosum (SCC), superior longitudinal fasciculus (SLF), posterior corona radiata (PCR), and posterior thalamic radiation (PTR) exhibited reduced microstructural integrity, strongly associated with SPD. Specifically, auditory over-responsivity, a subtype of SPD, was linked to impaired integrity of the PCR, PTR, anterior corona radiata, and SLF. Tactile over-responsivity (TOR) was correlated with markers of decreased integrity in the SCC, superior corona radiata, and left PTR. Among the DTI parameters, decreased fractional anisotropy (FA) emerged as the most reliable factor for identifying SPD, followed by increased radial diffusivity (RD) and mean diffusivity (MD). Notably, significant correlations were observed between with auditory over-responsivity and TOR with the DTI parameters (positive for FA and negative for RD and MD). Overall, this review confirms the impaired integrity of specific WM tracts in children with SPD and establishes correlations between DTI parameters and neurobehavioral deficits associated with the disorder. The insights gained from this review contribute to a better understanding of SPD and hold clinical implications for its diagnosis and treatment.

Analyzing Time Use by Occupation Area between Weekdays and Weekends by Gender of Parents in Single-Parent Families.

Introduction: Based on the "2019 Living Time Survey" data conducted by the National Statistical Office, this study is aimed at comparing the time usage of single-parent families by classifying the occupation area based on the fourth edition of the occupational therapy practice framework (OTPF) and dividing time use according to weekdays and weekends and by gender. Methods: After extracting the subjects who were selected belonging to a single-parent family from the original data of the "2019 Living Time Survey," 404 subjects who were single parents were selected, and the data were analysed. The sample consisted of 134 males and 270 females. The time usage by occupation area during weekdays and weekends and according to the gender of the subjects was checked. By using SPSS 25.0 version for data analysis, the general characteristics and time usage of subjects were presented as frequency analysis and technical statistics, and an independent sample t-test was conducted to compare time usage on weekdays and weekends. Results: Subjects spent more time on "education" and "work" on weekdays, and on weekends, they spent more time on "activities of daily living," "rest and sleep," "leisure," and "social participation." After classifying the subjects by gender, men spent more time on "work" on weekdays, and on weekends, they spent more time on "activities of daily living," "rest and sleep," "leisure," and "social participation." Women spent more time on "education" and "work" on weekdays, and on weekends, they spent more time on "rest and sleep," "leisure," and "social participation." Conclusion: By examining the time usage of single-parent families according to the day of the week, we hope that it will be used as basic data to suggest in which areas they have difficulty managing time, depending on the day of the week, and to establish solutions to insufficient time use due to gender differences.

Standardization of apple cancellation test for neglect patients in Korea: An observational study.

BACKGROUND: Neglect can be divided into two types using apple cancellation test (apple test): Egocentric neglect (EN) and allocentric neglect (AN). However, in South Korea, apple test results and decision criteria are still largely dependent on tests by foreign countries. AIM: To establish a new South Korea standard and improve the accuracy of neglect assessment, the apple experiment was standardized in this study. METHODS: This study was conducted on 223 healthy subjects for a total of 7 mo from August 2021 to February 2022. Standardization was carried out using the original apple test developed by Bickerton in 2011. In scoring for the apple test, total omission error refers to the number of missed targets (full apple) in the entire test sheet (left, middle, and right area). The score for EN is the difference between the cor-rect number of right area and the correct number of left area (excluding the middle area). For AN, the score is difference between the number of left opening apples and number of right opening apples (including the middle area). Linear regression analysis was used for standardization using the general characteristics of subjects and the results of the apple test. RESULTS: The cut-off score, which is the standard value indicating the pathological condition by combining the results of all subjects, is as follows: Total omission error (5), error for EN (2), and error for AN (2). Also, differences in cut-off score according to age were found. CONCLUSION: This study will be helpful in facilitating a more accurate differential diagnosis of neglect.

Digital Therapeutics for the Egocentric and Allocentric Neglects in Patients with Brain Injury: A Mini Review.

Various therapeutic approaches have been developed for neglect. Many studies have demonstrated the effect of digital therapeutics (DTx) on neglect. However, few studies have reported the effects of DTx on egocentric and allocentric neglect. The differentiation of types of neglect and separate interventions is crucial in the rehabilitation process. In this article, seven studies on DTx on egocentric and allocentric neglect were reviewed. DTx, which was employed in these studies, could be classified as follows: (1) software adaptation in traditional treatment, (2) VR game using the head-mount display as treatment, and (3) the development of a new digital program like ReMoVES. In addition, more studies and more effective results were reported for egocentric neglect than for allocentric neglect. In future studies, each effect on egocentric and allocentric neglect should be identified in detail with the appropriate use of differential evaluation and long-term application of independent DTx.

Time usage analysis and satisfaction comparison by occupational area according to the sex of single-parent families.

BACKGROUND: Single-parent families are burdened with dual roles as parents amidst economic poverty due to the lack of a spouse. Single parents also face the complications of time poverty. AIM: To examine the time use of single-parent families by dividing their time into occupational area and explore the differences in time deficiency and life satisfaction. METHODS: In this study, the time usage in the '2019 time of life survey' data of the National Statistical Office is classified based on the fourth edition of the Occupational Therapy Practice Framework, and the time use and satisfaction of single-parent families classified according to sex. In the '2019 time of life survey' of the National Statistical Office, the subjects who selected single-parent families in the 'single parent-parent-grandchild households' item were first selected. The data of 404 parents from single-parent families were selected next. The time usage, time deficiency, and life satisfaction were analyzed by occupational area. RESULTS: The subjects spent the most time resting and sleeping, followed by engaging in instrumental activities of daily living (IADLs), work, and health management. As a result of comparing the subjects by sex, it was found that the male subjects spent more time on work than the female subjects, and the female subjects spent more time on IADLs, education and social participation. As a result of comparing time deficiency and life satisfaction, the male subjects felt that they lacked time compared to the female subjects. There was no significant difference in life satisfaction. By examining whether single-parent families' time use by occupational area affected the time deficiency, it was found that male's working time make them feel they have less time, while female's leisure time makes them feel they have more time. CONCLUSION: This study made it possible to determine the characteristics of single-parent households' time use and sex differences. Furthermore, it is expected to be used as basic data for measures to solve not only time poverty, but also economic poverty in single-parent families.

Effects of Twins Therapy on Egocentric and Allocentric Neglect in Stroke Patients: A Feasibility Study.

(1) Background: Existing treatment methods for neglect are concentrated on egocentric neglect and may lead to various problems such as cost/space constraints and portability. Therefore, this study seeks to determine how a new treatment (also known as twins therapy, TT) for stroke patients can improve an existing problem associated with neglect. (2) Method: A pre/post-test control group research design was used and both groups continued to receive existing rehabilitation treatment, whilst TT intervention was only added to the experimental group. TT intervention was conducted for a total of 20 sessions (1 session for 30 min/day, 5 days/week, for 4 weeks). (3) Result: There was no significant difference in the manual function test (MFT) and the Korean version of the Modified Barthel Index (K-MBI) items (p > 0.05) before and after the TT intervention. However, the score and execution time of the apple cancellation test showed a significant reduction only in the experimental group (p < 0.05). (4) Conclusion: TT not only improved egocentric neglect, but also allocentric neglect symptoms in stroke patients.

Time usage analysis according to occupational area and satisfaction level in family caregivers of dementia patients.

Background: This study was designed to investigate the difference between the family caregivers of dementia patients (hereafter referred to as dementia family) and the non-family caregivers of dementia patients (hereafter referred to as non-dementia family) in terms of time usage. Methodology: A total of 102 dementia families who responded to the 'time use survey' in 2019 were enrolled in the study. 101 non-dementia families include families who did not respond to the 'dementia' item, and simple random sampling was performed. Time usage according to occupational area and satisfaction level were analyzed based on the Occupational Therapy Practice Framework-Fourth Edition (OTPF-4). Statistical analyses were completed using IBM SPSS 25. The data was analyzed by using frequency analysis and independent two-sample t-test. A level of p < 0.05 was used as a cut-off for statistical significance. Results: As for the time consumption by occupational area of dementia families and non-dementia families, dementia families spent more time than non-dementia families in instrumental daily life activities. The increase in the time for instrumental activities of daily living, including the time for caring for dementia patients, may lead to changes in time use for members of the family with dementia. By comparing the time usage by occupational area according to gender within the dementia families, it was possible to find out the difference between male and female instrumental daily activities and health care time use. The difference in time use according to gender showed that women took on more caring roles than men, and actually spent more time than men. Conclusion: The amount of time used between the dementia family and the non-dementia family differed according to the group and gender. These results suggest that dementia can cause changes in the time usage of dementia family. Therefore, this study recognizes the need for efficient use of time for dementia families and suggests that there is a need for a balanced use of time according to gender.

Assessment tools for differential diagnosis of neglect: Focusing on egocentric neglect and allocentric neglect.

BACKGROUND: There are very few studies on the differential diagnosis between egocentric neglect (EN) and allocentric neglect (AN). AIM: To investigate the overall trend of the previously developed assessment tools by conducting a descriptive review of the studies on assessment tools that can perform a differential diagnosis of EN and AN. METHODS: The data were collected by using databases such as Google Scholar, PubMed, and ScienceDirect. The most commonly used search terms were "neglect", "stroke", "egocentric neglect", and "allocentric neglect". RESULTS: A total of seven studies that met the inclusion criteria were selected and analyzed. We were able to confirm the research process, test method, and differential diagnosis criteria of the seven presented assessment tools from four studies on paper-based tests and three studies on computerized tests. The majority of the tests were carried out via the cancellation method using stimuli such as everyday objects or numbers. EN distinguished the left from right based on the test paper, while AN distinguished the left from right based on stimuli. In order to perform differential diagnosis, the difference in the number of left and right responses or non-responses was used based on the EN and AN criteria. CONCLUSION: It was confirmed that all the seven assessment tools can effectively perform differential diagnosis of EN and AN. This study may provide important data that can be used in clinical practice for differential diagnosis and future intervention planning for neglect patients.

Mental health and quality of life in firefighters working on the scene in South Korea: Focused on the capital area and the ground pro-motion area.

INTRODUCTION: Today, firefighters' work areas are expanding into various fields. The aim of the study was to investigate the effect of mental health on quality of life between firefighters in the capital area and in the growth promotion area. METHOD: A survey was conducted with 206 firefighters including 110 firefighters in the capital area and 96 firefighters in the growth promotion area through a questionnaire. RESULT: The differences in mental health based on working areas between firefighter groups have been identified. In addition, among the factors affecting the quality of life among firefighter, the factor most closely associated with quality of life was "sociopsychological health stress," followed by "occupational stress," "depression," and "working area." CONCLUSION: There is a need for research into mental health interventions appropriate for regional characteristics of each region regarding the implementation of mental health management by working area.

The different association of allocentric and egocentric neglect with dorsal and ventral pathways: A case report.

RATIONALE: Egocentric neglect is characterized by responses missing on the contralateral side with respect to the viewer, while allocentric neglect is characterized in responses missing on the contralateral side with respect to the object . However, little has been reported about the neural tracts associated with egocentric and allocentric neglect. We investigated which neural tracts were involved in two types of neglect (egocentric and allocentric) in a stroke patient who showed allocentric neglect by using the Apple Cancellation test, a specialized test to distinguish between egocentric and allocentric neglect. PATIENT CONCERNS: He showed good cognitive function but presented with severe neglect on the left side (A 42-year-old, right-handed male patient). He was unable to undergo even the pencil and paper test for evaluation of the severity of neglect. DIAGNOSES: He was diagnosed as spontaneous intracerebral hemorrhage at the right basal ganglia and underwent conservative management at the neurosurgery department of a university hospital. INTERVENTIONS: Two weeks after onset, he began rehabilitation at the rehabilitation department of the same university hospital. During a seven month rehabilitation, the patient showed significant improvement of his severe left neglect. OUTCOMES: We used the Apple Cancellation test to distinguish between egocentric and allocentric neglect; the results failed to reveal egocentric neglect, however, they did reveal severe allocentric neglect. In addition, on diffusion tensor tractography (DTT) at 2 weeks after onset, the right superior longitudinal fasciculus (SLF) showed partial injury and narrowing in the parietal lobe compared to that of the left SLF. In addition, the right inferior fronto-occipital fasciculus (IFOF) was not reconstructed. By contrast, on 7-month post-onset DTT, the right SLF revealed elongation and thickening in the parietal lobe that approached similarity to that for the left SLF. However, the right IFOF was still not reconstructed. LESSONS: The associations of egocentric neglect with the dorsal pathway (SLF) and the association of allocentric neglect with the ventral pathway (IFOF) in the right hemisphere were demonstrated in a stroke patient. It appears that DTT can be helpful in demonstrating both the affected pathway and the neglect type in patients with neglect.

The allocentric neglect due to injury of the inferior fronto-occipital fasciculus in a stroke patient: A case report.

RATIONALE: We report on a patient who developed allocentric neglect due to injury of the inferior fronto-occipital fasciculus (IFOF) following intracranial hemorrhage, diagnosed using diffusion tensor tractography (DTT). PATIENT CONCERNS: Her cognition seemed normal (A 17-year-old, right-handed female patient). However, in spite of a normal visual field, her perception was missing on the left side, and she had no awareness of her deficit. She was unable to perceive the left side in each of 2 objects, regardless of position of the 2 objects, and failed at detail exploration of the left side of 1 object. In addition, the line bisection test, the most representative neglect test, did not reveal any abnormality. DIAGNOSES: She was diagnosed with an intracerebral hemorrhage (right thalamus), intraventricular hemorrhage, and subarachnoid hemorrhage due to arteriovenous malformation in the right thalamus. INTERVENTIONS: Seven weeks after onset, she began rehabilitation. Consequently, the apple cancellation test to discriminate between allocentric and egocentric neglect was performed, with the result of severe allocentric neglect. OUTCOMES: The right superior longitudinal fasciculus and inferior longitudinal fasciculus were well-reconstructed without definite injury compared with those of the left side. However, the right IFOF was discontinued in the anterior portion around the frontal lobe. LESSONS: Allocentric neglect due to injury of IFOF was demonstrated in a stroke patient using DTT. It appears that DTT would be helpful in demonstrating the neglect type and pathway in patients with neglect.

Difference in cortical activation during use of volar and dorsal hand splints: a functional magnetic resonance imaging study.

There have been no studies reported on the difference in cortical activation during use of volar and dorsal hand splints. We attempted to investigate the difference in cortical activation in the somatosensory cortical area during use of volar and dorsal hand splints by functional magnetic resonance imaging (fMRI). We recruited eight healthy volunteers. fMRI was performed while subjects who were fitted with volar or dorsal hand splints performed grasp-release movements. Regions of interest were placed on the primary motor cortex (M1), primary somatosensory cortex (S1), posterior parietal cortex (PPC), and secondary somatosensory cortex (S2). Results of group analysis of fMRI data showed that the total numbers of activated voxels in all ROIs were significantly higher during use of volar hand splint (3,376) compared with that (1,416) during use of dorsal hand splint. In each ROI, use of volar hand splint induced greater activation in all ROIs (M1: 1,748, S1: 1,455, PPC: 23, and S2: 150) compared with use of dorsal hand splint (M1: 783, S1: 625, PPC: 0, and S2: 8). The peak activated value was also higher during use of volar hand splint (t-value: 17.29) compared with that during use of dorsal hand splint (t-value: 13.11). Taken together, use of volar hand splint induced greater cortical activation relevant to somatosensory function than use of dorsal hand splint. This result would be important for the physiatrist and therapist to apply appropriate somatosensory input in patients with brain injury.

The effect of a finger training application using a tablet PC in chronic hemiparetic stroke patients.

Twenty-one consecutive patients were randomly assigned to either the intervention group (10 patients) or the control group (11 patients). The application consisted of three sections (registration, evaluation, and training) and the training section consisted of five programs (stretching, flexion, extension, opposition, and thumb abduction). Application training consisted of 1 session (31 min)/day, 6 days/week for 4 weeks. We found that our application training was effective in terms of the motor function of the affected hand: Manual Muscle Test of the wrist and finger extensors, the Manual Function Test (subtest of manipulative activity), and the Purdue Pegboard Test.

Ideomotor Apraxia Due to Injury of the Superior Longitudinal Fasciculus.

We report on a patient who showed ideomotor apraxia due to injury of the superior longitudinal fasciculus following brain tumor and tumor bleeding, which was demonstrated by diffusion tensor tractography (DTT). A 60-yr-old, right-handed male patient underwent removal of brain meningioma and drainage of intraventricular hemorrhage and intracerebral hemorrhage in the left fronto-parietal lobe. At the time of DTT scanning (5 wk after onset), he was able to move the right upper extremity against gravity. The patient exhibited an intact ideational plan for motor performance. In addition, he was able to use actual objects (scissors, eraser) using his right wrist and hand. However, he had difficulty in using his right upper extremity for pantomime of object use, imitating gestures (meaningless or meaningful), and movement of his right upper extremity proximal. Score on the ideomotor apraxia test for the right side was 4 (cut-off score < 32). DTTs for the left superior longitudinal fasciculus to the left premotor cortex and left inferior parietal lobule showed partial injury, compared with the right superior longitudinal fasciculus. These injuries appeared to be the reason for ideomotor apraxia in this patient.

Change of the Corticospinal Tract in the Unaffected Hemisphere by Change of the Dominant Hand Following Stroke: A Cohort Study.

We investigated the change of the corticospinal tract (CST) in the unaffected hemisphere by the change of the dominant hand in stroke patients, using diffusion tensor tractography (DTT).Forty-eight stroke patients with right-hand dominance were recruited. The patients were assigned to 3 groups: group A (12 patients)-right-hand dominance was maintained after the right-hand weakness, group B (17 patients)-right-hand dominance changed to the left-hand dominance after the right-hand weakness, and group C (19 patients)-right-hand dominance was maintained after the left-hand weakness had developed. The function of the unaffected upper extremity was evaluated using the grip strength (GS), Manual Function Test (MFT), Purdue Pegboard Test (PPT), and modified Barthel Index (MBI). DTT was performed twice (1st DTT, 2nd DTT), and the fractional anisotropy (FA), apparent diffusion coefficient (ADC), and voxel number (VN) of the CST in the unaffected hemisphere were measured.In group B, the VN on 2nd DTT was significantly increased compared with the 1st DTT, and all other clinical data (GS, MFT, PPT, and MBI) showed a significant increase between 1st and 2nd DTT (P < 0.05). The change of the VN showed moderate correlation with the change of the GS (r = 0.499, P < 0.05), PPT (r = 0.531, P < 0.05), and MBI (r = 0.551, P < 0.05).We found that the fiber number of the CST in the unaffected hemisphere was increased by the change of the dominant hand in stroke patients. We believe that our results have important implications in terms of neurorehabilitation.

The cortical effect of chewing gum during hand movements: A functional MRI study.

Nine right-handed normal subjects were recruited for this study. We compared the cortical activation during execution of hand movements (right finger flexion-extension) with that during execution of hand movements while chewing gum (right side chewing). We found that execution of hand movements while chewing gum induced less activation in the contralateral SM1 than hand movements alone. Based on our findings, it appears chewing gum during execution of hand movements enhanced the efficiency of hand movements.