Tag Archives: patient

Use of Prism Glasses in PSP questionnaire now live!

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Coronavirus has meant many of our projects have ground to a halt, but in spite of the disruption we’ve been pressing on by moving some research online. Something we’re delighted to be making progress with is Dan Ford and James Ireland’s MSc project, which explores the use of prism glasses by people with Progressive Supranuclear Palsy (PSP). People with PSP often have problems looking downwards, which makes it hard for them to see what is happening in the lower visual field. Many everyday tasks like eating, reading and using a computer rely on being able to look down into the lower part of the visual field, which makes them very difficult for people with PSP. Prism glasses bend the light so that that the lower visual field can be seen without having to move the eyes. They are cheap and easy to use, so appear to have great potential as a compensatory tool. They are widely used to treat other neurological disorders which affect vision, such has hemispatial neglect and hemianopia.

However, prisms do have some disadvantages. For example, they can be heavy and it takes time to get used to the way they change how the world looks. Furthermore, nobody really knows how useful they are or how widely used they are because nobody has asked people with PSP. Dan and James’s project aims to start answering this important issue by surveying people with PSP about their attitudes towards, and experiences of, using prism glasses. It’s one of the first surveys of its kind and we’re hoping that the results will help us better understand how people use prisms, whether they find them useful, and/or the problems or impediments that people experience when using prism glasses. If you have PSP and would like to take part the questionnaire can be found here:

https://durhampsychology.eu.qualtrics.com/jfe/form/SV_eqxcolUWzqVSPjv

Dan and James are being supervised by Dr Alison Lane and the project is a collaboration with the PSP Association.  You can find out more about Dr Ali Lane’s research on neurorehabilitation on her homepage.

If you are interested, some of our related research can be found here:

 

 

Federation of European Neuropsychology Societies 2019: Conference Report

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In my final conference of a busy summer I attended the Federation of European Neuropsychology Societies (FESN) which took place from 5th -7th September in Milan. I arrived on the 4th and stayed in the conference hotel “Palazzo Delle Stellene” which was a converted monastery right beside the church that houses Michelangelo’s Last Supper. The hotel was very atmospheric, although the plumbing was a bit noisy and there was a long queue for the single coffee machine at breakfast! The talks on the first day didn’t start until lunchtime, so after breakfast I strolled down to the Piazza del Duomo to take the obligatory selfie at both ends of the square for use in lectures on neglect 😉 .

Looking across the Piazza Del Duomo from the steps of the Duomo

The conference itself was hosted in the Universita Cattolica del Sacro Coure, which is  housed in the cloisters of the beautiful old monastery of Sant’Ambrogio. The main auditorium (Aula Magna) was richly decorated, as was the Crypt, which held some of the other sessions. This grandeur did come at a cost, as the rooms tended to be long and narrow which wasn’t brilliant for their acoustics and meant it could be hard to read detail on some slides. The opening address was an interesting and unusually political appeal to science administrators and governments to protect researchers doing animal work. It was followed by a keynote from Emrah Duzel explaining the functional anatomy of episodic memory loss in Alzhiemers disease, then lunch in the grounds. After lunch I attended the ‘Body in the Brain’ symposium, which discussed recent developments in the understanding of embodiment and then an excellent session on networks of attentional control chaired by Alfredo Spanga. My main take homes from this session were that the old idea that the right hemisphere is specialised for spatial attention has really stood the test of time, but also that people in this field really neglect the role of the oculomotor system in visuospatial attention.  

Looking along the cloisters

Speaking of attention and eye-movements, my talk was on ‘Associations and dissociations between oculomotor readiness and covert attention’ and was part of a Colloquium organised by Thomas Schenk. As the talks was only 15 mins I covered our the studies on attention within and beyond the range of eye movements we recently published in Cortex (Casteau & Smith 2018) and only touched on the broader literature, which we reviewed in Casteau & Smith (2019). I was more nervy than usual about this talk, partly because it was in Italy, which I think of as the home of Premotor theory, and partly because I knew several of my old bosses (Thomas and Steve Jackson) would be there and I wanted to put on a good show. Unfortunately I was last in the evening session so attendance was a wee bit sparse, but in the end I think it went quite well, and I got some good questions from Steve and Janet Bultitude afterwards. The other speakers were Ana Chica, who gave a very nice talk on the motoric and perceptual effects of Inhibition of Return, Christian Poth who demonstrated that there is some trans-saccadic competition between unattended objects and Karin Ludwig, who reported experiments showing that visual scanning training can bias attention in healthy participants. In the following days I attended some fascinating talks on Neglect in the symposium organed by Monika Harvey and saw a superb keynote from Carlo Miniussi on the challenges of applying neurostimulation techniques such as tDCS to neurorehabilitation. Masud Husain also gave an excellent talk on apathy, showing that in many cases the core problem is that patients are not motivated by outcomes with high rewards. I also attended the poster sessions, but as these were only an hour long and over lunch I didn’t see as many as I would have liked. There was some excellent work, and I particularly enjoyed Monika Halika’s poster “Disputing neglect-like symptoms in unilateral chronic pain” which showed there is no unilateral attentional bias in chronic pain patients with upper limb pain using a TOJ task. 

I had not been to FESN before and I thought there were some interesting comparisons between it and ECEM, which Soazig & I had attended earlier in the summer (you can read a report here). The

The Aula Magna, viewed from the stage. There were a few more people by the time my talk started!

meetings felt of a similar size, with around 400-500 delegates and this gave them both a feeling of intimacy and offered excellent opportunities for catching up with friends and colleagues and meeting new people. If anything FESN offered me more opportunities for ‘networking’ (as opposed to gossiping with old friends). A nice example of this was probably the couple of hours I spent in the company of Thomas and Sergio Della Salla, listening to them discuss the state of academic publishing. It was interesting to hear a perspective from ‘inside’ the industry (Thomas is former section editor for Neuropsychologia and Sergio the EiC of Cortex). It was also a salutatory lesson in the power of personal contact; for some time I’ve harboured an ambition to edit a special issue but not really known how to go about it. I tentatively mentioned this to Sergio, only to have him beckon seductively while crooning ‘send it to me…’. So, watch this space!  The conference registration fee was quite high at 400 euro for early, non-members, but as with ECEM this included excellent plentiful lunches and a welcome reception. Although the meeting was intimate it felt a bit more formal than ECEM, with many delegates adopting a ‘smart causal’ look or even suits, despite the warm weather. The talks themselves also tended to have a more sober delivery, perhaps as Christian Poth suggested, because many of the delegates were also clinicians and were discussing research related to their own patients.

Overall I thought it was an excellent meeting with a very high standard of talk. The highlight was probably Miniussi’s talk on tDCS, although I was also very tickled when Radek Ptak approached Thomas and I saying “Hey! You’re the Premotor Theory guys!”. I would definitely consider attending FESN again and it would be an excellent forum to present the results from our more applied neuropsychological work on Attention & Memory in Progressive Supranuclear Palsy and Parkinson’s Disease (e.g. Smith & Archibald 2019) .

Casteau, S. & Smith, D.T. (2019). Associations and Dissociations between Oculomotor Readiness and Covert Attention. Vision 3(2): 17
Casteau, S. & Smith, D.T. (2018). Covert Attention Beyond the Range of Eye-movements: Evidence for a Dissociation between Exogenous and Endogenous orienting. Cortex

RIO Group conference report

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Last week Soazig and I had a very enjoyable couple of days at the annual RIO (Research in Imagery & Observation) group meeting held at Teesside University. Now, imagery isn’t our usual sort of thing, but the chance to attend a free conference in our own backyard seemed to good to miss. On day 1 we saw some fascinating presentations from students in Shaun Boe’s lab who had travelled all the way from Dalhousie in Canada. The first thing to note  is that most of the contemporary research was focused on AOMI (which everyone pronounced AY-OH-ME, much to Soazigs irritation). AOMI involves action observation (i.e. watching an expert do the task) while simultaneously engaging in mental imagery (imagining performing the action). The key message I took from these talks was that although it was generally agreed that mental imagery was jolly helpful for improving skills, there was no real agreement about either the optimal ‘dosage’ or at what point during skill acquisition AOMI was most effective. Boe’s group showed some pretty nice evidence that AOMI was most effective during skill acquisition; the ‘cognitive’ and ‘associative’ phases in Fitts & Posner (1967) model of expertise. In a particularly interesting finding, Sarah Kraeutner argued that imagery could reduce endpoint variability without necessarily improving overall accuracy in a dart throwing task. However, a number of audience members commented that although the dart-throwing paradigm is a classic task, it has problems as a model of skill acquisition, particularly with respect to controlling prior experience of the task. Also in this session was a fascinating talk from Jack Binks on using imagery to rehabilitate motor skills after stoke. Richard Ramsay then gave an eclectic keynote covering cognitive and brain mechanisms of social perception, which I found particularly interesting with respect to our work with Geoff Cole on perspective taking and social attention.

On day 2 Soazig and I did presentations on topics that, to be fair, were a bit tangentially related to mental imagery. Soazig presented our preliminary data on the effects of TMS over FEF on presaccadic and premotor shifts of attention. The cool result here is that the neurostimulation disrupts presaccadic attention but has no effect on the pre-reaching shift of attention. I presented some neuropsychological  demonstrating that patients with Progressive Supranuclear Palsy have a deficit of VSWM that maps onto their oculomotor paralysis (see Smith & Archibald 2019). I argued this research had more direct relevance for mental imagery, as there is evidence that making eye-movements can interfere with the generation of visual imagery (e.g. Andrade, Kavanagh & Baddeley 1997), followed by a cheeky plug for our own workshop in July. I discussed the overlap between eye-movements, imagery and attention at some length with Dan Eaves (Teesside), and we were both struck by the fact that there are motor theories of attention, such as Kleins Oculomotor Readiness Hypothesis (OMRH) & Rizzolatti’s Premotor Theory (PMT), and motor theories of mental imagery such as Jeannerods Motor Simulation Theory. However, there seems to be little effort to reconcile or integrate these views, and we agreed this could be an area that is ripe for further study.  The day 2 keynote was given by Robert Hardwick (KU Leuven), who presented a fascinating meta-analysis of studies examining imagery, action observation and action execution, and finished with an appeal to develop more theoretically principled models of mental imagery. Again, I was struck by the parallels between the dominance of Simulation Theory in the motor imagery literature and that of OMRH/PMT in the literature on spatial attention, and the need to develop beyond these ideas. There was also time for a bit of light schmoozing around the posters, and I was delighted to talk briefly with Zoe Franklin about TMS and eyetracking, Elaine Poliakoff about her work on imagery in Parkinsons Disease, Shaun Boe about his ideas on the neural and cognitive mechanisms underpinned AOMI, Gabriel Valadez Roque about using imagery to rehabilitate stroke patients in Mexico and Martin Edwards, with whom I mainly exchanged academic gossip 😉.

The final session was a discussion led by Stefan Vogt which touched on future directions for imagery research. Naturally I made sure I had my 2 cents worth about motor theories of attention and imagery. There was also a prize for the best student contribution, which was won by Sylvia Chiou from Bielefeld for her excellent talk “Is temporal information integrated with spatial information during action observation? Effects of visual attention on the processing of whole-body movement sequences”. After all that excitement we retired to the Dickens Inn where refreshments were taken. Hats off to Dan Eaves for chairing such a well organised and welcoming conference, particularly for AOMI neophytes like me and Soazig. I was also very impressed with the Teesside Uni campus, and the quality and affordability of the catering. I would highly recommend attending the RIO group meeting to anyone with an interest in action observation, imagery or motor learning.

If you are interested in the research we presented my slides can be found here: RIO group talk

Our Cortex paper describing a deficit of spatial working memory in PSP is open access and can be found here: https://www.sciencedirect.com/science/article/pii/S0010945218302211?via%3Dihub

Smith, D.T. & Archibald, N. (2018). Spatial Working Memory in Progressive Supranuclear Palsy. Cortex