Deans' stroke musings: Triple dissociation of attention networks in stroke according to lesion location

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, August 27, 2013

Triple dissociation of attention networks in stroke according to lesion location

Your doctor can come up with some protocols for this. ASK I know my doctor did nothing about this. My attention was so bad I once fell asleep listening to my speech therapist.
http://www.neurology.org/content/81/9/812.abstract?sid=7b7456af-c9a4-4426-b8f6-4cae6e552b3d

Paul Rinne, MSc,
Mursyida Hassan, MSc,
Despina Goniotakis, MSc,
Kiran Chohan, DPhil,
Pankaj Sharma, MD, FRCP, PhD,
Dawn Langdon, PhD,
David Soto, PhD and
Paul Bentley, MRCP, PhD

+Show Affiliations

Correspondence to Dr. Bentley: p.bentley@imperial.ac.uk

Published online before print July 31, 2013, doi: 10.1212/WNL.0b013e3182a2ca34 Neurology August 27, 2013 vol. 81 no. 9 812-820

Abstract

Objective: To determine whether behavioral dissociations and interactions occur between the attentional functions—alerting, orienting, and conflict resolution—depending upon stroke location and to determine the approximate proportion of patients who can be classified into 1 of these 3 anatomical networks.

Methods: We recruited 110 anatomically unselected acute stroke patients and 62 age-matched controls. Subjects underwent the attention network test (ANT), which provides a measure of each attention type. Their performance was related to lesion anatomy on MRI using a voxel-lesion mapping approach.

Results: Patients as a whole performed poorer than controls, but there were no group differences in the size of attentional effects. Specific deficits in 1 of the 3 ANT-tested functions were found in the following lesion locations: alerting deficiency with bilateral anteromedial thalamus and upper brainstem (17% of patients); orienting impairment with right pulvinar and right temporoparietal cortex (15%); conflict resolution with bilateral prefrontal and premotor areas (23%). Lesions to right frontoparietal regions also modified interactions among the 3 types of attention.

Conclusions: More than half of all stroke patients can be expected to have a lesion location classifiable into 1 of the 3 principal attention networks. Our results have potential implications for therapy personalization in focal brain diseases including stroke.