Week 2: Articles Flashcards
What was the main goal of Bucara & Papagno’s review?
To determine whether rTMS and tDCS have long-lasting effects on naming performance in post-stroke aphasia.
What kind of study design did they use?
Systematic review and meta-analysis (PRISMA guidelines).
What types of studies were included?
• Adults with post-stroke aphasia
• Intervention with rTMS or tDCS
• Naming task outcome
• Follow-up of at least 1 week
How many total studies were analyzed?
11 studies: 5 on rTMS, 6 on tDCS
What was the effect size of rTMS?
Moderate to large, with sustained improvements in naming.
In which patient groups was rTMS effective?
Both chronic and subacute post-stroke patients.
What enhanced rTMS outcomes?
Combining rTMS with speech-language therapy (SLT).
Were there safety concerns with rTMS?
No major side effects reported.
What was the GRADE quality for rTMS evidence?
Moderate to high
What was the effect size of tDCS?
Small to moderate, less consistent than rTMS.
In which patients was tDCS effective long-term?
Primarily chronic patients; no benefit in subacute cases.
What limited tDCS generalizability?
Protocol heterogeneity and small sample sizes.
What was the GRADE quality for tDCS evidence?
Low
What neuroplasticity-based rationale supports these interventions?
• Inhibitory rTMS over right hemisphere homologues
• Excitatory tDCS over left perilesional areas
What factors influence effectiveness of stimulation?
• Timing (chronic vs. subacute)
• Individual differences
• Stimulation parameters
What is the overall conclusion about rTMS?
It is a robust, long-lasting treatment for naming deficits, especially when paired with SLT.
What is the overall conclusion about tDCS?
It shows potential in chronic aphasia but needs more rigorous research.
What do the authors recommend for future studies?
Larger samples, better controls, and longer follow-ups, especially for tDCS.
What core question does Vaidya’s study investigate?
Whether VMF damage impairs emotional facial expression recognition due to deficits in visual exploration or interpretation.
Why is this important for social functioning?
Accurate emotion recognition is crucial for effective social interaction and understanding others’ states.
Who were the participants?
• 17 patients with VMF lesions
• 20 with frontal control (FC) lesions
• 26 healthy controls
What imaging method was used to map lesions?
Clinical imaging, followed by expert categorization and voxel-based lesion symptom mapping (VLSM).
What were the three viewing conditions used?
- Free Viewing – rate emotional intensity
- Gaze-Contingent Viewing – gaze-controlled viewing
- Instructed Viewing – fixate only on the eyes
What types of expressions were shown?
Neutral, subtle, and extreme expressions (Karolinska faces).
What emotional recognition deficit was observed in VMF patients?
Reduced recognition specifically for subtle disgust, not fear or happiness.
How did VMF patients perform with extreme expressions?
Slightly reduced specificity, especially for disgust.
Did VMF-damaged patients show abnormal gaze behavior?
No – fixations, heatmaps, and region viewing were normal.
What does this suggest about the deficit’s origin?
The deficit lies in interpreting, not acquiring, visual information.
Did instructing all groups to fixate the eyes help?
Yes, it improved subtle fear recognition across all groups but did not eliminate the VMF group’s deficits.
How is VMF damage distinct from amygdala damage?
VMF patients show normal gaze, unlike amygdala-damaged individuals who avoid the eyes.
What cognitive role is suggested for the VMF?
Interpreting valence/arousal, managing ambiguity, and understanding emotional meaning.
What broader cognitive functions did FC patients show difficulty in?
Top-down attention control, affecting visual prioritization.
What broader implications does the study have?
It suggests that disorders like autism may involve interpretation deficits, not just attention problems.
Did VLSM identify specific voxels correlated with deficits?
No voxel-wise correlations reached significance, indicating distributed contributions.
