Papers by Elena Calzolari
Brain Sciences
Visuo-motor adaptation to optical prisms (Prism Adaptation, PA), displacing the visual scene late... more Visuo-motor adaptation to optical prisms (Prism Adaptation, PA), displacing the visual scene laterally, is a behavioral method used for the experimental investigation of visuomotor plasticity, and, in clinical settings, for temporarily ameliorating and rehabilitating unilateral spatial neglect. This study investigated the building up of PA, and the presence of the typically occurring subsequent Aftereffects (AEs) in a brain-damaged patient (TMA), suffering from apperceptive agnosia and a right visual half-field defect, with bilateral atrophy of the parieto-occipital cortices, regions involved in PA and AEs. Base-Right prisms and control neutral lenses were used. PA was achieved by repeated pointing movements toward three types of stimuli: visual, auditory, and bimodal audio-visual. The presence and the magnitude of AEs were assessed by proprioceptive, visual, visuo-proprioceptive, and auditory-proprioceptive straight-ahead pointing tasks. The patient’s brain connectivity was investi...
Journal of the Neurological Sciences
bioRxiv, 2021
Activation of the peripheral vestibular apparatus simultaneously elicits a reflex vestibular nyst... more Activation of the peripheral vestibular apparatus simultaneously elicits a reflex vestibular nystagmus and the vestibular perception of self-motion (vestibular-motion perception) or vertigo. In a newly characterised condition called Vestibular Agnosia found in conditions with disrupted brain network connectivity, e.g. traumatic brain injury (TBI) or neurodegeneration (Parkinson’s Disease), the link between vestibular reflex and perception is uncoupled, such that, peripheral vestibular activation elicits a vestibular ocular reflex nystagmus but without vertigo. Using structural brain imaging in acute traumatic brain injury, we recently linked vestibular agnosia to postural imbalance via disrupted right temporal white-matter circuits (inferior longitudinal fasciculus), however no white-matter tracts were specifically linked to vestibular agnosia. Given the relative difficulty in localizing the neuroanatomical correlates of vestibular-motion perception, and compatible with current theo...
Vestibular Agnosia - where peripheral vestibular activation triggers the usual reflex nystagmus r... more Vestibular Agnosia - where peripheral vestibular activation triggers the usual reflex nystagmus response but with attenuated or no self-motion perception - is found in brain disease with disrupted cortical network functioning, e.g. traumatic brain injury (TBI) or neurodegeneration (Parkinson’s Disease). Patients with acute focal hemispheric lesions (e.g. stroke) do not manifest vestibular agnosia. Thus brain network mapping techniques, e.g. resting state functional MRI (rsfMRI), are needed to interrogate functional brain networks mediating vestibular agnosia. Whole-brain rsfMRI was acquired from 39 prospectively recruited acute TBI patients with preserved peripheral vestibular function, along with self-motion perceptual thresholds during passive yaw rotations in the dark. Following quality-control checks, 25 patient scans were analyzed. TBI patients were classified as having vestibular agnosia (n = 11) or not (n = 14) via laboratory testing of self-motion perception. Using independe...
Brain, 2020
Vestibular dysfunction, causing dizziness and imbalance, is a common yet poorly understood featur... more Vestibular dysfunction, causing dizziness and imbalance, is a common yet poorly understood feature in patients with TBI. Damage to the inner ear, nerve, brainstem, cerebellum and cerebral hemispheres may all affect vestibular functioning, hence, a multi-level assessment—from reflex to perception—is required. In a previous report, postural instability was the commonest neurological feature in ambulating acute patients with TBI. During ward assessment, we also frequently observe a loss of vertigo sensation in patients with acute TBI, common inner ear conditions and a related vigorous vestibular-ocular reflex nystagmus, suggesting a ‘vestibular agnosia’. Patients with vestibular agnosia were also more unbalanced; however, the link between vestibular agnosia and imbalance was confounded by the presence of inner ear conditions. We investigated the brain mechanisms of imbalance in acute TBI, its link with vestibular agnosia, and potential clinical impact, by prospective laboratory assessm...
Attention, Perception, & Psychophysics, 2020
The distances between pairs of tactile stimuli oriented across the width of the hand dorsum are p... more The distances between pairs of tactile stimuli oriented across the width of the hand dorsum are perceived as about 40% larger than equivalent distances oriented along the hand length. Clear anisotropies of varying magnitudes have been found on different sites on the limbs and less consistently on other parts of the body, with anisotropies on the center of the forehead, but not on the belly. Reported anisotropies on the center of the forehead, however, might reflect an artefact of categorical perception from the face midline, which might be comparable to the expansion of tactile distance perception observed for stimuli presented across joint boundaries. To test whether tactile anisotropy is indeed a general characteristic of the tactile representation of the face, we assessed the perceived distance between pairs of touches on the cheeks and three locations on the forehead: left, right, and center. Consistent with previous results, a clear anisotropy was apparent on the center of the forehead. Importantly, similar anisotropies were also evident on the left and right sides of the forehead and both cheeks. These results provide evidence that anisotropy of perceived tactile distance is not a specific feature of tactile organization at the limbs but it also exists for the face, and further suggest that the spatial distortions found for tactile distances that extend across multiple body parts are not present for stimuli that extend across the body midline.
Journal of Concussion, 2018
The Sports Concussion Assessment Tool 3rd version is a sports screening tool that is often used t... more The Sports Concussion Assessment Tool 3rd version is a sports screening tool that is often used to support return to play decisions following a head injury. The Sports Concussion Assessment Tool 3rd version is presumed to identify brain dysfunction (implying a degree of brain injury); however, the Sports Concussion Assessment Tool has never been validated with patients with definite acute brain injury. In this study, we found that all three Sports Concussion Assessment Tool 3rd version domains – symptoms, cognitive and balance assessments – were sensitive in discriminating traumatic brain injury patients (all with abnormal acute neuroimaging) from healthy controls. Through a correlation matrix (Bonferroni corrected), we found no correlation between the subjective (symptoms) and objective (examination) Sports Concussion Assessment Tool 3rd version assessments, e.g. complaints of imbalance and memory dysfunction were not correlated, respectively, with performance on testing balance an...
Scientific Data, 2018
The human emotional reactions to stimuli delivered by different sensory modalities is a topic of ... more The human emotional reactions to stimuli delivered by different sensory modalities is a topic of interest for many disciplines, from Human-Computer-Interaction to cognitive sciences. Different databases of stimuli eliciting emotional reaction are available, tested on a high number of participants. Interestingly, stimuli within one database are always of the same type. In other words, to date, no data was obtained and compared from distinct types of emotion-eliciting stimuli from the same participant. This makes it difficult to use different databases within the same experiment, limiting the complexity of experiments investigating emotional reactions. Moreover, whereas the stimuli and the participants’ rating to the stimuli are available, physiological reactions of participants to the emotional stimuli are often recorded but not shared. Here, we test stimuli delivered either through a visual, auditory, or haptic modality in a within participant experimental design. We provide the res...
Cortex, 2018
Prism adaptation is a well-known method used to investigate brain plasticity, and a promising tec... more Prism adaptation is a well-known method used to investigate brain plasticity, and a promising technique for the rehabilitation of unilateral spatial neglect (USN). Only little evidence about the mechanisms of prism adaptation (PA) in patients with left-brain damage is on record, and about putative differences of PA, and the aftereffects (AEs), between patients with left and right brain damage. In the present study, PA and the AEs were assessed in 30 brain-damaged patients, 20 with right-sided lesions (10 with and 10 without USN), and 10 with left-sided lesions without USN, as well as in a control group of 24 age-matched participants. All patients underwent adaptation to lenses shifting the field of vision towards the side of the lesion, followed by two measures for detecting AEs: the proprioceptive (P) and the visuo-proprioceptive (VP) straight-ahead tasks. To investigate the temporal course of AEs in the different groups, the two measures were recorded immediately and 10 minutes after PA. Before PA, and at the end of the 10-minute delayed evaluation, two tasks to assess USN (target cancellation and drawing) were also administered. All patients adapted to prisms. However, left-brain-damaged (LBD) patients presented with reduced AEs, as compared with right-braindamaged (RBD) patients with USN. Moreover, while both controls and LBD patients adapting to leftshifting prisms had reduced VP AEs in the delayed condition, AEs were not different from zero (i.e., no AEs) in LBD patients. Finally, in the delayed condition USN patients showed an improvement in the drawing, but not in the cancellation, tasks. These results suggest that adaptation to leftward shifting lenses is associated with larger decay of VP AEs, and a role of the left hemisphere in maintaining these AEs after PA. These findings can be of relevance for the clinical application of this technique in neurological populations.
Cortex; a journal devoted to the study of the nervous system and behavior, Jan 18, 2018
Spatial neglect is a debilitating disorder frequently observed after damage to the right cerebral... more Spatial neglect is a debilitating disorder frequently observed after damage to the right cerebral hemisphere. Previous investigations have revealed that prism adaptation (PA) therapy can lead to improvements in neglect-related symptoms. In the typical PA protocol patients repeatedly point toward a visual target while wearing prism goggles. A few years ago, a novel PA procedure, involving a variety of more "ecological" visuo-motor activities during adaptation, less repetitive than a sequence of pointings, was introduced by our research group, and shown to be able to improve neglect-related symptoms to the same extent as the standard pointing task. The ecological procedure was easy to administer and pleasant for the patients. In all previous studies, patients were treated by specialized personnel during hospitalization. In the current study, we investigated the effectiveness of the ecological PA method when performed in a home-based setting, with the help of caregivers and f...
Frontiers in human neuroscience, 2017
Visuo-motor adaptation to optical prisms displacing the visual scene (prism adaptation, PA) is a ... more Visuo-motor adaptation to optical prisms displacing the visual scene (prism adaptation, PA) is a method used for investigating visuo-motor plasticity in healthy individuals and, in clinical settings, for the rehabilitation of unilateral spatial neglect. In the standard paradigm, the adaptation phase involves repeated pointings to visual targets, while wearing optical prisms displacing the visual scene laterally. Here we explored differences in PA, and its aftereffects (AEs), as related to the sensory modality of the target. Visual, auditory, and multisensory - audio-visual - targets in the adaptation phase were used, while participants wore prisms displacing the visual field rightward by 10°. Proprioceptive, visual, visual-proprioceptive, auditory-proprioceptive straight-ahead shifts were measured. Pointing to auditory and to audio-visual targets in the adaptation phase produces proprioceptive, visual-proprioceptive, and auditory-proprioceptive AEs, as the typical visual targets did...
Handbook of clinical neurology, 2018
Unilateral spatial neglect is a disabling neurologic deficit, most frequent and severe after righ... more Unilateral spatial neglect is a disabling neurologic deficit, most frequent and severe after right-hemispheric lesions. In most patients neglect involves the left side of space, contralateral to a right-hemispheric lesion. About 50% of stroke patients exhibit neglect in the acute phase. Patients fail to orient, respond to, and report sensory events occurring in the contralateral sides of space and of the body, to explore these portions of space through movements by action effectors (eye, limbs), and to move the contralateral limbs. Neglect is a multicomponent higher-level disorder of spatial awareness, cognition, and attention. Spatial neglect may occur independently of elementary sensory and motor neurologic deficits, but it can mimic and make them more severe. Diagnostic tests include: motor exploratory target cancellation; setting the midpoint of a horizontal line (bisection), that requires the estimation of lateral extent; drawing by copy and from memory; reading, assessing negl...
Proceedings of the National Academy of Sciences of the United States of America, Apr 10, 2017
The stage at which processing of tactile distance occurs is still debated. We addressed this issu... more The stage at which processing of tactile distance occurs is still debated. We addressed this issue by implementing an adaptation-aftereffect paradigm with passive touch. We demonstrated the presence of a strong aftereffect, induced by the simultaneous presentation of pairs of tactile stimuli. After adaptation to two different distances, one on each hand, participants systematically perceived a subsequent stimulus delivered to the hand adapted to the smaller distance as being larger. We further investigated the nature of the aftereffects, demonstrating that they are orientation- and skin-region-specific, occur even when just one hand is adapted, do not transfer either contralaterally or across the palm and dorsum, and are defined in a skin-centered, rather than an external, reference frame. These characteristics of tactile distance aftereffects are similar to those of low-level visual aftereffects, supporting the idea that distance perception arises at early stages of tactile process...
Behavioural brain research, 2016
The physiological regulation of skin temperature can be modulated not only by autonomic brain reg... more The physiological regulation of skin temperature can be modulated not only by autonomic brain regions, but also by a network of higher-level cortical areas involved in the maintenance of a coherent representation of the body. In this study we assessed in healthy participants if the sensorimotor changes taking place during motor adaptation to the lateral displacement of the visual scene induced by wearing prismatic lenses (prism adaptation, PA), and the aftereffects, after prisms' removal, on the ability to process spatial coordinates, were associated with skin temperature regulation changes. We found a difference in thermoregulatory control as a function of the direction of the prism-induced displacement of the visual scene, and the subsequent sensorimotor adaptation. After PA to rightward displacing lenses, with leftward aftereffects (the same directional procedure efficaciously used for ameliorating left spatial neglect in right-brain-damaged patients) the hands' temperatu...
Neuropsychologia, 2015
Adaptation to optical prisms displacing the visual scene laterally is a widely investigated insta... more Adaptation to optical prisms displacing the visual scene laterally is a widely investigated instance of visuo-motor plasticity, also because prism adaptation (PA) has been extensively used as a treatment for right-brain-damaged patients suffering from left spatial neglect. The lateral visual displacement brought about by prisms, as indexed by a pointing error in the direction of the displacement, is progressively corrected through repeated pointings: after prism removal, a shift in the direction opposite to the prism-induced deviation occurs in visual, proprioceptive, and visuo-proprioceptive straight-ahead tasks (aftereffects, AEs). The cerebellum and the posterior parietal cortex (PPC) are key components of the bilateral cerebral network subserving the AEs, and the reduction of the pointing error during prism exposure in PA. We report the experimental study of a patient with bilateral occipital and left cerebellar damage, who showed a preserved reduction of the pointing errors to rightward displacing prisms, but not the leftward AEs in the proprioceptive straight-ahead task; instead, visual-proprioceptive and visual AEs were preserved. Anodal transcranial Direct Current Stimulation (tDCS) over the left PPC restored the leftward proprioceptive AEs, and anodal tDCS over the left cerebellum abolished the rightward deviation. Conversely, stimulation over the right PPC or the right cerebellum was ineffective. These results provide novel evidence for neuromodulatory effects of tDCS on defective AEs, through the stimulation over dedicated cortical regions.
Frontiers in human neuroscience, 2013
Prism adaptation improves a wide range of manifestations of left spatial neglect in right-brain-d... more Prism adaptation improves a wide range of manifestations of left spatial neglect in right-brain-damaged patients. The typical paradigm consists in repeated pointing movements to visual targets, while patients wear prism goggles that displace the visual scene rightwards. Recently, we demonstrated the efficacy of a novel adaptation procedure, involving a variety of every-day visuo-motor activities. This "ecological" procedure proved to be as effective as the repetitive pointing adaptation task in ameliorating symptoms of spatial neglect, and was better tolerated by patients. However, the absence of adaptation and aftereffects measures for the ecological treatment did not allow for a full comparison of the two procedures. This is important in the light of recent findings showing that the magnitude of prism-induced aftereffects may predict recovery from spatial neglect. Here, we investigated prism-induced adaptation and aftereffects after ecological and pointing adaptation pro...
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Papers by Elena Calzolari