Neuroanatomy of hemispatial neglect and its functional - Brain
Training The Brain 4 Recent Developments Neglect
-
Upload
bodyin-mind -
Category
Business
-
view
3.954 -
download
2
description
Transcript of Training The Brain 4 Recent Developments Neglect
![Page 1: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/1.jpg)
Lorimer MoseleyNHMRC Senior Research FellowPrince of Wales Medical Research Institute & Faculty of Medicine, University of NSW, Sydney, Australia
CRPS Rehabilitation (or training the brain)
www.bodyinmind.com.au Copyright GL Moseley 2009 Complex Regional Pain
Syndrome
![Page 2: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/2.jpg)
Why train the brain?
CRPS as an extreme protective response.
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 3: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/3.jpg)
Why train the brain?
Cognitive
Understanding the problem
Other threatening cues are relevant
Educate & explain
Behavioural
Function & movement hierarchy
‘training the brain part 1’
Brain changes
S1 reorganisation
Reorganisation elsewhere?
‘training the brain part 2’
Recent developments
Neglect and ownership
Disrupted bodily awareness
Disruption of high-order cognitive
representations.
www.bodyinmind.com.au Copyright GL Moseley 2009
Our approach to treating CRPS
![Page 4: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/4.jpg)
Why train the brain?
Neglect and ownership
www.bodyinmind.com.au Copyright GL Moseley 2009
Recent developments
![Page 5: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/5.jpg)
Does it feel like it is mine?Many patients report feelings of
foreigness & hostility towards the limb.
“I feel like it is not mine, like it is an imposter”
Lewis et al 2008 Pain
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 6: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/6.jpg)
Could this ‘disownership’ contribute to symptoms?
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 7: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/7.jpg)
The rubber hand illusion
Mo
sele
y e
t a
l 200
8 PN
AS
105(
35),
131
69-7
3www.bodyinmind.com.au
Copyright GL Moseley 2009
![Page 8: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/8.jpg)
10
0
-1º
-1º
0º
0º
Ctl CtlRHI
60 s
Vividness of RHI
Foot temperature
Hand temperature
The rubber hand illusion
Mo
sele
y e
t a
l 200
8 PN
AS
105(
35),
131
69-7
3www.bodyinmind.com.au
Copyright GL Moseley 2009
![Page 9: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/9.jpg)
10
32.0
33.0
Control Rubber hand illusion
Mo
sele
y e
t a
l 200
8 PN
AS
105(
35),
131
69-7
3www.bodyinmind.com.au
Copyright GL Moseley 2009
![Page 10: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/10.jpg)
10
32.0
33.0
Control Rubber hand illusion
Pre PostM
ose
ley
et
al 2
008
PNA
S 10
5(35
), 1
3169
-73
www.bodyinmind.com.au
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 11: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/11.jpg)
10
29.5
30.5
Pre Post
Time0 52
RHISynchronous tapping eyes
closed
Mo
sele
y e
t a
l 200
8 PN
AS
105(
35),
131
69-7
3www.bodyinmind.com.au
Copyright GL Moseley 2009
![Page 12: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/12.jpg)
10
-1º
0º
Vividness of the illusion0 105
R =0.50*
Skin temperature
Mo
sele
y e
t a
l 200
8 PN
AS
105(
35),
131
69-7
3www.bodyinmind.com.au
Copyright GL Moseley 2009
![Page 13: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/13.jpg)
Yes.
Could this ‘disownership’ contribute to symptoms?
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 14: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/14.jpg)
The neglect question...
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 15: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/15.jpg)
Vibrator
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 16: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/16.jpg)
Vibrator
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 17: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/17.jpg)
Vibrator
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 18: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/18.jpg)
Vibrator
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 19: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/19.jpg)
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 20: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/20.jpg)
Stimulator
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 21: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/21.jpg)
Stimulator
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 22: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/22.jpg)
Stimulator
Left
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 23: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/23.jpg)
Stimulator
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 24: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/24.jpg)
Stimulator
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 25: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/25.jpg)
Stimulator
Right
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 26: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/26.jpg)
In chronic CRPS, you have to stimulate the
affected hand about 25ms
before the other to think the
stimuli occurred at the same
time
Moseley et al 2009 Brain (published on-line 150909)
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 27: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/27.jpg)
But when you cross your arms,
the opposite occurs - you
have to stimulate the UNaffected
20ms before the affected to
think the stimuli occurred at the
same timeMoseley et al 2009 Brain (published on-line 150909)
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 28: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/28.jpg)
This shows that the bigger the shift in
processing, the colder the limb is,
relative to the opposite one.
Moseley et al 2009 Brain (published on-line 150909)
The shift away from the affected limb is opposite to what we see with acute threatening stimuli Van Damme et al 2009 Brain Res.
2009;1253:100-106.
www.bodyinmind.com.au Copyright GL Moseley 2009
![Page 29: Training The Brain 4 Recent Developments Neglect](https://reader033.fdocuments.in/reader033/viewer/2022052901/55653d70d8b42a902d8b458a/html5/thumbnails/29.jpg)
Why train the brain?
Recent developments
Disrupted bodily awareness
Disruption of high-order cognitive
representations.
www.bodyinmind.com.au Copyright GL Moseley 2009
Go to the next set of slides on Recent Developments