Does vestibular stimulation activate thalamocortical mechanisms that reintegrate impaired cortical regions?
Caloric stimulation induced a transient reversal of multimodal hemispatial cognitive deficits in an 81-year-old woman with an acute left cerebral hemisphere stroke. The patient had unawareness of her right hand (asomatognosia), right-sided visual unawareness (hemineglect), aphasia and right-sided weakness (hemiplegia) prior to the stimulation. Transient improvements in impaired sensory, motor, linguistic and cognitive function developed within 30 s following application of the caloric stimulus and onset of horizontal nystagmus. The effect persisted for 3 min and ceased completely after 5 min. While several recent reports have described the capacity of caloric stimulation to transiently improve or reverse a wide range of attentional, cognitive and motor impairments, most examples are in right-hemisphere-damaged patients with long-standing brain injury. Typically, patients have been tested several months or years after the onset of the deficit. A possible mechanism for the temporary reintegration of multiple cognitive functions in this patient is discussed.
Schiff
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ND
New York Hospital-Cornell Medical Center, Department of Neurology and Neuroscience, NY 10021, USA.
Pulver
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M
D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D001364:Awareness; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000534:rehabilitation; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000534:rehabilitation; D017679:Cryotherapy; D004424:Ear Canal; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010812:Physical Stimulation / Q000379:methods; D013702:Temporal Lobe / Q000503:physiopathology*; D007507:Therapeutic Irrigation / Q000379:methods