A comparison of errorless and errorful therapies for dysgraphia after stroke.

Despite the increasing significance of written communication, there is limited research into spelling therapy for adults with acquired dysgraphia. Existing studies have typically measured spelling accuracy as an outcome, although speed may also be important for functional writing. As spelling is relatively slow, effortful and prone to errors in people with dysgraphia, minimising errors within therapy could be a factor in therapy success. This within-participant case-series study investigated whether errorless and errorful therapies would differ in their effects on spelling speed and accuracy for four participants with acquired dysgraphia. Matched sets of words were treated with errorless or errorful therapy or left untreated. Results were collated one week and five weeks after therapy. Both therapy approaches were successful in improving spelling accuracy. For three participants, equivalent gains were demonstrated following errorless and errorful therapy. One participant made significantly greater improvements in spelling accuracy following errorless therapy. The effects were maintained five weeks later. There was no significant difference in post-therapy spelling speed between the two therapy conditions. The results of this study suggest that both errorful and errorless therapies can be effective methods with which to treat spelling in adults with acquired dysgraphia

Dissociating Object Directed and Non-Object Directed Action in the Human Mirror System; Implications for Theories of Motor Simulation

Mirror neurons are single cells found in macaque premotor and parietal cortices that are active during action execution and observation. In non-human primates, mirror neurons have only been found in relation to object-directed movements or communicative gestures, as non-object directed actions of the upper limb are not well characterized in non-human primates. Mirror neurons provide important evidence for motor simulation theories of cognition, sometimes referred to as the direct matching hypothesis, which propose that observed actions are mapped onto associated motor schemata in a direct and automatic manner. This study, for the first time, directly compares mirror responses, defined as the overlap between action execution and observation, during object directed and meaningless non-object directed actions. We present functional MRI data that demonstrate a clear dissociation between object directed and non-object directed actions within the human mirror system. A premotor and parietal network was preferentially active during object directed actions, whether observed or executed. Moreover, we report spatially correlated activity across multiple voxels for observation and execution of an object directed action. In contrast to predictions made by motor simulation theory, no similar activity was observed for non-object directed actions. These data demonstrate that object directed and meaningless non-object directed actions are subserved by different neuronal networks and that the human mirror response is significantly greater for object directed actions. These data have important implications for understanding the human mirror system and for simulation theories of motor cognition. Subsequent theories of motor simulation must account for these differences, possibly by acknowledging the role of experience in modulating the mirror response

Structural Changes in Thalamic Nuclei across Prodromal and Clinical Alzheimer's Disease

Background: Increasing evidence suggests that thalamic nuclei may atrophy in Alzheimer's disease (AD). We hypothesized that there will be significant atrophy of limbic thalamic nuclei associated with declining memory and cognition across the AD continuum. Objective: The objective of this work was to characterize volume differences in thalamic nuclei in subjects with early and late mild cognitive impairment (MCI) as well as AD when compared to healthy control (HC) subjects using a novel MRI-based thalamic segmentation technique (THOMAS). Methods: MPRAGE data from the ADNI database were used in this study (n = 540). Healthy control (n = 125), early MCI (n = 212), late MCI (n = 114), and AD subjects (n = 89) were selected, and their MRI data were parcellated to determine the volumes of 11 thalamic nuclei for each subject. Volumes across the different clinical subgroups were compared using ANCOVA. Results: There were significant differences in thalamic nuclei volumes between HC, late MCI, and AD subjects. The anteroventral, mediodorsal, pulvinar, medial geniculate, and centromedian nuclei were significantly smaller in subjects with late MCI and AD when compared to HC subjects. Furthermore, the mediodorsal, pulvinar, and medial geniculate nuclei were significantly smaller in early MCI when compared to HC subjects. Conclusion: This work highlights nucleus specific atrophy within the thalamus in subjects with early and late MCI and AD. This is consistent with the hypothesis that memory and cognitive changes in AD are mediated by damage to a large-scale integrated neural network that extends beyond the medial temporal lobes

The Neurotopography of Written Word Production: An fMRI Investigation of the Distribution of Sensitivity to Length and Frequency

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