Tanja Nijboer

University Medical Center Utrecht | UMC Utrecht · Department of Rehabilitation and Sports Medicine

In the assessment of visual working memory, estimating the maximum capacity is currently the gold standard. However, traditional tasks disregard that information generally remains available in the external world. Only when to-be-used information is not readily accessible, memory is taxed. Otherwise, people sample information from the environment as...

Objectives: The 'attentional spotlight' can be adjusted depending on the task requirements, resulting in processing information at either the local or global level. Stroke can lead to local or global processing biases, or the inability to simultaneously attend both levels. In this study, we assessed the (1) prevalence of abnormal local and global...

The Mobility Assessment Course (MAC) is a tool to measure visuospatial neglect in a dynamic fashion. Although the MAC has been shown to dissociate between patients with and without neglect, it remains unclear whether it is applicable in clinical settings. We evaluated the MAC regarding its (1) feasibility as a diagnostic tool as part of standard ca...

Conventional neuropsychological tests do not represent the complex and dynamic situations encountered in daily life. Immersive virtual reality simulations can be used to simulate dynamic and interactive situations in a controlled setting. Adding eye tracking to such simulations may provide highly detailed outcome measures, and has great potential f...

Background: Cognitive performances on neuropsychological paper-and-pencil tests are generally evaluated quantitatively by examining a final score (e.g., total duration). Digital tests allow for a quantitative evaluation of "how" a patient attained a final score, which opens the possibility to assess more subtle cognitive impairment even when final...

Stroke patients with visuospatial neglect (VSN) have difficulties responding to visual information located in the contralesional hemifield, affecting many daily life activities (ADL) such as eating, reading and mobility. Visual Scanning Therapy (VST) is widely used in clinical practice to ameliorate symptoms of VSN. Yet, not all patients benefit fr...

Every saccade is generally preceded by a mandatory shift of attention to the saccade endpoint, allowing us to process visual information more effectively. Whether this ‘pre-saccadic shift of attention’ is still intact in hemispatial neglect is unknown. Whereas neglect patients exhibit lateralized impairments of attention and often show impaired sac...

Visuospatial neglect (VSN) adversely impacts both the length of rehabilitation and activities of daily living (ADL) of patients after stroke and can reduce their participation in community activities. Therefore, it is important to assess VSN after stroke in neurorehabilitation facilities. The process of assessing VSN comprehensively in current geri...

Background Cognitive deficits have been frequently assessed in brain tumor patients. However, self-reported cognitive complaints received little attention so far. Cognitive complaints are important as they often interfere with participation in society. In this study, cognitive complaints were systematically assessed in brain tumor patients. As pati...

Introduction: Impairments in visual search are a common symptom in visuospatial neglect (VSN). The severity of the lateralized attention bias in visual search tasks can vary depending on the number of distractors: the more distractors, the more targets are missed. However, little is known about how the number of targets affect search performance i...

Virtual Reality (VR) offers the possibility to assess cognitive functioning in a dynamic environment resembling daily life. In this cross-sectional study, we used two user interfaces, namely non-immersive VR by using a computer monitor (CM) and immersive VR by using a head-mounted display (HMD). We investigated (1) potential differences in feasibil...

Introduction: Digital neuropsychological assessment (d-NPA) has several advantages over paper-and-pencil tests in neuropsychological assessment, such as a more standardized stimulus presentation and response acquisition. We investigated (1) the feasibility and user-experience of a d-NPA in patients with acquired brain injury (ABI) and healthy cont...

Introduction Numerous tests of visuo-spatial neglect (VSN) have been developed. In this study, we propose a clustering of VSN tests by making a distinction between static tests with low levels of cognitive demand (i.e. tests without movement or time-restrictions, such as paper-and-pencil tests) and dynamic tests with high levels of cognitive demand...

Introduction Amyotrophic lateral sclerosis (ALS) is a fatal disorder characterized by the progressive loss of upper and lower motor neurons. ALS has traditionally been classified within the domain of neuromuscular diseases, which are a unique spectrum of disorders that predominantly affect the peripheral nervous system. However, over the past decad...

Objective: Patients with amyotrophic lateral sclerosis (ALS) not only show motor deficits, but may also have cognitive and/or behavioral impairments. Recognizing these impairments is crucial as they are associated with lower quality of life, shorter survival, and increased caregiver burden. Therefore, ALS-specific neuropsychological screening instr...

Purpose: Youth with physical disabilities have lower psychosocial health and attention compared to their typically developing peers. Recent research has shown positive associations between sports participation and these outcomes. The purpose of the current study was to explore whether a school-based sports program affects psychosocial health and a...

Attention allows us to select important sensory information and enhances sensory information processing. Attention and our motor system are tightly coupled: attention is shifted to the target location before a goal-directed eye- or hand movement is executed. Congruent eye–hand movements to the same target can boost the effect of this pre-movement s...

Visual perception is introspectively stable and continuous across eye movements. It has been hypothesized that displacements in retinal input caused by eye movements can be dissociated from displacements in the external world using extra-retinal information, such as a corollary discharge from the oculomotor system. The extra-retinal information can...

Visuospatial neglect (VSN) is characterized by a lateralized attentional deficit in the visual domain. In addition, patients with VSN might have an impairment in the temporary storage of spatial information in working memory (spatial working memory; SWM) that, like VSN, could impair systematic searching behavior. Several studies have demonstrated e...

Cognitive difficulties can be subtle and only come to light when patients return home from inpatient care and start to participate in society. Subjective cognitive complaints often interfere with participation, hence capturing cognitive complaints systematically is important. We developed a patient- and relative-reported measure to assess cognitive...

Introduction Approximately 30% of all patients with stroke show visuospatial neglect (VSN). Currently, visual scanning therapy (VST) is applied in clinical settings to attenuate neglect symptoms. VST builds on the premise that eye movements to the affected hemifield lead to a concurrent shift of visual attention. Congruent movements with different...

The classic rubber hand illusion (RHI) experiment studies the sense of embodiment over a fake limb. Distinguished subcomponents of embodiment are ownership (sense of self-attribution of a body), agency (sense of having motor control), and self-location (the spatial experience of being inside a body), and are typically evoked in either reality or vi...

Here, we provide a case-report of an amyotrophic lateral sclerosis (ALS) patient with cognitive deficits best defined as posterior cortical atrophy (PCA). This is an unusual finding as ALS forms a spectrum with frontotemporal dementia (FTD), whereas PCA is predominantly associated with Alzheimer’s disease pathology. We hypothesize on whether ALS wi...

Objectives Visuospatial neglect (VSN) is a common cognitive disorder after stroke. The primary aim of this systematic review was to provide an overview of the impact of VSN in 3 aspects: (1) activities of daily living (ADL), (2) participation, and (3) caregiver burden. The second aim was to investigate the differences in studies focusing on populat...

Background: Primary lateral sclerosis (PLS) is a rare motor neuron disease characterized by progressive degeneration of upper motor neurons, resulting in spasticity and disability. There is, however, mounting evidence that the disease is not limited to upper motor neurons alone and that cognitive and behavioral changes within the spectrum of fronto...

Introduction: Cognitive impairment after stroke has been associated with lower quality of life and independence in the long run, stressing the need for methods that target impairment for cognitive rehabilitation. The use of noninvasive brain stimulation (NIBS) on recovery of language functions is well documented, yet the effects of NIBS on other c...

The integration of information from multiple senses leads to a plethora of behavioral benefits, most predominantly to faster and better detection, localization, and identification of events in the environment. Although previous studies of multisensory integration (MSI) in humans have provided insights into the neural underpinnings of MSI, studies o...

Even though we frequently execute saccades, we perceive the external world as coherent and stable. An important mechanism of trans-saccadic perception is spatial remapping: the process of updating information across eye movements. Previous studies have indicated a right hemispheric dominance for spatial remapping, which has been proposed to transla...

When individuals are exposed to a constant change of the interplay with their environment, they are able to develop compensatory alterations of visuo-motor coordination in order to counteract the perturbation. Prism adaptation (PA) is a very simple tool that has been used for several decades to investigate adaptive processes. However, the specific...

Patients with visuospatial neglect (VSN) suffer from an imbalance in visual attention between their left and right (egocentric or allocentric) hemispace. The view of VSN as an attentional imbalance between two hemispaces ignores the fact that—in our daily life—we are presented with varying levels of stimulus density, within but also across hemispac...

Humans move their eyes several times per second, yet we perceive the outside world as continuous despite the sudden disruptions created by each eye movement. To date, the mechanism that the brain employs to achieve visual continuity across eye movements remains unclear. While it has been proposed that the oculomotor system quickly updates and infor...

Background: The Edinburgh cognitive and behavioral ALS screen (ECAS) was developed specifically to detect cognitive and behavioral changes in patients with amyotrophic lateral sclerosis (ALS). Differences with regard to normative data of different (language) versions of neuropsychological tests such as the ECAS exist. Objective: To derive norms...

Background Visuo‐spatial neglect (VSN) is generally assessed with neuropsychological paper‐and‐pencil tasks, which are often not sensitive enough to detect mild and/or well‐compensated VSN. It is of utmost importance to develop dynamic tasks, resembling the dynamics of daily living. Objective A simulated driving task was used to assess (1) differe...

Accurate tests of cognition are vital in (neuro)psychology. Cancellation tasks are popular tests of attention and executive function, in which participants find and ‘cancel’ targets among distractors. Despite extensive use in neurological patients, it remains unclear whether demographic variables (that vary among patients) affect cancellation perfo...

Objectives Cognitive and behavioural changes within the spectrum of frontotemporal dementia (FTD) are observed frequently in patients with amyotrophic lateral sclerosis (ALS). Whether these changes also occur in other forms of motor neuron disease (MND) is not well studied. We therefore systemically screened a large cohort of patients with primary...

Background and purpose: There is growing evidence that visuospatial neglect (VSN) is associated with lower functional performance in other modalities and is not restricted to the lesioned hemisphere alone, and may also affect the non-lesioned hemisphere in severe first-ever strokes. We aimed to investigate the longitudinal association between the...

Introduction: Visuospatial neglect can occur in peripersonal and extrapersonal space. The dorsal visual pathway is hypothesized to be associated with peripersonal, and the ventral pathway with extrapersonal neglect. We aimed to evaluate neural substrates of peripersonal versus extrapersonal neglect, separately for egocentric and allocentric frames...

Highlights - Cancellation tasks are useful clinical tools that probe many cognitive modules - We used cancellation tests on 523 participants of different ages, sex, and education - We provide cancellation task norm scores for indices computed from a big sample - Cancellation indices include attention bias, processing speed and search organisation -...

In general, moving sensory stimuli (visual and auditory) can induce illusory sensations of self-motion (i.e. vection) in the direction opposite of the sensory stimulation. The aim of the current study was to examine whether tactile stimulation encircling the waist could induce circular vection (around the body's yaw axis) and to examine whether thi...

Objectives: Stroke could lead to deficits in organization of visual search. Cancellation tests are frequently used in standard neuropsychological assessment and appear suitable to measure search organization. The current aim was to evaluate which cognitive functions are associated with cancellation organization measures after stroke. Methods: St...

Background: Patients with neglect ignore or respond slower to contralesional stimuli. Neglect negatively influences independence in activities of daily living (ADL). Prism adaptation (PA) is one of the most frequently studied treatments, yet there is little evidence regarding positive effects on neglect behavior in ADL. Objective: To assess whet...

Background Stroke can result in cognitive complaints that can have a large impact on quality of life long after its occurrence. A number of computer-based training programs have been developed with the aim to improve cognitive functioning. Most studies investigating their efficacy used only objective outcome measures, whereas a reduction of subject...

Protocol approved by medical ethical committee_TAPASS_V1.1. (PDF)

CONSORT 2010 checklist_TAPASS_Subjective. (PDF)

Subjective brain training effects after stroke. (PDF)

TAPASS_Subj_CVA_minimal data excl demo info. (SAV)

Mean (standard deviation) and MANOVA of the outcome measures of per-protocol analyses. (PDF)

Results: Left USN (15.82%) was more frequent than right USN (9.25%). Demographic and stroke characteristics were comparable between groups. The lateralized attentional deficit was most severe in left USN. USN in both peripersonal and extrapersonal space was more frequently left-sided in nature. Search efficiency was lower in left USN. Balance was...

Objective: Primary lateral sclerosis (PLS) is a rare form of motor neuron disease characterised by UMN degeneration leading to slowly progressive spasticity. Whether it is a separate disease or a subtype of ALS has been debated. In ALS comorbid frontotemporal dementia (FTD) is frequently seen (±15%). However, cognitive and behavioural changes are...

Spontaneous motor recovery after stroke appears to be associated with structural and functional changes in the motor network. The aim of the current study was to explore time-dependent changes in resting-state (rs) functional connectivity in motor-impaired stroke patients, using rs-functional MRI at 5 weeks and 26 weeks post-stroke onset. For this...

Explicit protocol. (DOC)

CONSORT 2010 checklist. (DOC)

Introduction: Visual neglect is a frequent disorder following stroke and is often diagnosed by neuropsychological assessment. However, paper-and-pencil tasks have low predictive value as they lack sensitivity to capture neglect in complex, dynamic situations, such as activities of daily living. Aims of the current study were to assess the feasibil...

A large proportion of stroke patients are unable to return to work (RTW), although figures vary greatly. A total of 121 mild-to-moderate stroke patients, who had a paid job at the time of their stroke were included (a) to quantify RTW and work satisfaction one-year post-stroke (using the Utrecht Scale for Evaluation of Rehabilitation-Participation)...

In this experiment, we demonstrate modulation of the pupillary light response by spatial working memory (SWM). The pupillary light response has previously been shown to reflect the focus of covert attention, as demonstrated by smaller pupil sizes when a subject covertly attends a location on a bright background compared to a dark background. We too...

Visuo-spatial neglect can occur after both right and left hemisphere damage. It is generally accepted that left-sided neglect is more severe than right-sided neglect with respect to the lateralized attention deficit. In the current study, comparisons were made between left-sided and right-sided neglect with respect to frequency, severity, and regio...

Korsakoff's syndrome (KS) is a neuropsychiatric disorder characterised by severe amnesia. Although the presence of impairments in memory has long been acknowledged, there is a lack of knowledge about the precise characteristics of declarative memory capacities in order to implement memory rehabilitation. In this study, we investigated the extent to...

Tijdschrift voor Neuropsychologie Naast conventionele cognitieve tests kunnen dynamische cognitieve tests van toegevoegde waarde zijn bij het bepalen van de cognitieve leermogelijkheden van patiënten met niet-aangeboren hersenletsel (NAH). Een dynamische testprocedure evalueert het effect van een kortdurende training op de cognitieve testprestatie...

Brain training is currently widely used in an attempt to improve cognitive functioning. Computer-based training can be performed at home and could therefore be an effective add-on to available rehabilitation programs aimed at improving cognitive functioning. Several studies have reported cognitive improvements after computer training, but most lack...

Improvement on training tasks of the intervention group (n = 36) and the active control group (n = 33). Scores are the average of all training tasks performed (max is 2000, for active control group max should be 900). Error bars represent standard errors. The lines are offset horizontally to reveal both lines. (PDF)