Browsing by Author "Stinear, Cathy"

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    Multisensory attention training for treatment of tinnitus
    (Scientific Reports, 2016-05) Spiegel, Daniel; Linford, Tania; Thompson, Ben; Petoe, Matthew; Kobayashi, Kei; Stinear, Cathy; Searchfield, Grant
    Tinnitus is the conscious perception of sound with no physical sound source. Some models of tinnitus pathophysiology suggest that networks associated with attention, memory, distress and multisensory experience are involved in tinnitus perception. The aim of this study was to evaluate whether a multisensory attention training paradigm which used audio, visual, and somatosensory stimulation would reduce tinnitus. Eighteen participants with predominantly unilateral chronic tinnitus were randomized between two groups receiving 20 daily sessions of either integration (attempting to reduce salience to tinnitus by binding with multisensory stimuli) or attention diversion (multisensory stimuli opposite side to tinnitus) training. The training resulted in small but statistically significant reductions in Tinnitus Functional Index and Tinnitus Severity Numeric Scale scores and improved attentional abilities. No statistically significant improvements in tinnitus were found between the training groups. This study demonstrated that a short period of multisensory attention training reduced unilateral tinnitus, but directing attention toward or away from the tinnitus side did not differentiate this effect.
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    Proportional recovery after stroke depends on corticomotor integrity
    (to American Neurological Association, 2015-11-17) Byblow, Winston; Stinear, Cathy; Barber, Alan; Petoe, Matthew; Ackerley, Suzanne
    OBJECTIVE: For most patients the resolution of upper limb impairment during the first six months after stroke is 70% of the maximum possible. We sought to identify candidate mechanisms of this proportional recovery. We hypothesized that the proportional resolution of upper limb impairment depends on ipsilesional corticomotor pathway function, is mirrored by the proportional recovery of excitability in this pathway, and is unaffected by upper limb therapy dose. METHOD: Upper limb impairment was measured in 93 patients at 2, 6, 12 and 26 weeks after first-ever ischaemic stroke. Motor evoked potentials and motor threshold were recorded from extensor carpi radialis using transcranial magnetic stimulation, and fractional anisotropy in the posterior limbs of the internal capsules was determined with diffusion-weighted MRI. RESULTS: Initial impairment score, the presence of motor evoked potentials and fractional anisotropy asymmetry were the only predictors of impairment resolution, indicating a key role for corticomotor tract function. By 12 weeks, upper limb impairment resolved by 70% in patients with motor evoked potentials regardless of their initial impairment, and ipsilesional rest motor threshold also resolved by 70%. The resolution of impairment was insensitive to upper limb therapy dose. INTERPRETATION: These findings indicate that upper limb impairment resolves by 70% of the maximum possible regardless of initial impairment, but only for patients with intact corticomotor function. Impairment resolution seems to reflect spontaneous neurobiological processes that involve the ipsilesional corticomotor pathway. A better understanding of these mechanisms could lead to interventions that increase the resolution of impairment above 70%. This article is protected by copyright. All rights reserved.