Tim Vanbellingen

Luzerner Kantonsspital | LUKS · neurology and neurorehabilitation center

Background Persons with Parkinson’s disease (PD) often exhibit difficulties with dexterity during the performance of activities of daily living (ADL), inter alia due to dysfunctional supplementary motor area (SMA). Combined intermittent theta-burst stimulation (iTBS) over the SMA followed by video game-based training (VBT) may therefore improve dex...

Objectives Apraxia is a common syndrome of left hemispheric stroke. A parieto-premotor-prefrontal network has been associated with apraxia, in which the left inferior parietal lobe (IPL-L) plays a major role. We hypothesized that transcranial continuous theta burst stimulation (cTBS) over the right inferior parietal lobe (IPL-R) improves gesturing...

Purpose: Mobile health applications (mHealth apps) may lead to health benefits. In recent years, the use of apps in multiple sclerosis (MS) has increased. Apps to train and improve dexterity in MS are scarce. This study investigated the effectiveness of a tablet app-based home-based training to improve dexterity in individuals with MS. Materials...

In everyday life, information from different cognitive domains - such as visuospatial attention, alertness, and inhibition - needs to be integrated between different brain regions. Early models suggested that completely segregated brain networks control these three cognitive domains. However, more recent accounts, mainly based on neuroimaging data...

Background: To reduce healthcare costs, it has become increasingly important to shorten the length of stay in acute stroke units. The goal of this study was to develop and externally validate a decision tree model applicable < 48 h poststroke for discharge home from an acute stroke unit with a short length of stay, and to assess the inappropriate...

This pilot cross-sectional study aimed to evaluate the usability of two new interactive game sensor-based hand devices (GripAble and Smart Sensor Egg) in both healthy adults as well as in persons with Parkinson’s Disease (PD). Eight healthy adults and eight persons with PD participated in this study. Besides a standardised usability measure, the st...

Introduction: Deficits in social interaction and community functioning, including impaired use, performance, and perception of hand gestures, are key features in schizophrenia. A well-established tool to assess gesture deficits is the test of upper limb apraxia (TULIA). However, given its time-consuming application based on video analyses, researc...

Introduction At hospital stroke units, the time available to assess the patient's limitations in activities and participation is limited, although being essential for discharge planning. Till date, there is no quick-to-perform instrument available that captures the patient's actual performance during daily activities from a motor, cognitive, and co...

Background: Cognitive decline affects up to 50% of patients with Parkinson's disease (PD) in the course of the disease and may be amenable to exercise interventions. To accurately set adequate training intensities, standardized exercise testing is required but such testing takes considerable time and effort. The aim of this pilot study was to inve...

Background: An early treatment start with disease modifying therapies (DMT) and long-term adherence is crucial in the treatment of people with multiple sclerosis (PwMS) to prevent future disability. Objectives: To gain information on the diagnostic process, decision making, treatment start and adherence with regard to DMT as well as satisfaction in...

Welche Unterstützung benötigt ein Mensch mit erworbener Hirnschädigung, um wieder seinen Beruf auszuüben? Dieser Frage geht die Work-ability Support Scale auf den Grund. Das Besondere an dem Assessment: Neben dem persönlichen Unterstützungsbedarf erfasst die WSS außerdem die Kontextfaktoren rund um den Arbeitsplatz.

Introduction: Patients with Parkinson's disease (PD) often exhibit difficulties with dexterity during the performance of activities of daily living (ADL) due to dysfunctional supplementary motor area (SMA). The aim of this clinical trial protocol work is to describe how the effectiveness of a combined repetitive transcranial magnetic stimulation (r...

Background Flow is a subjective psychological state that people report when they are fully involved in an activity to the point of forgetting time and their surrounding except the activity itself. Being in flow during physical/cognitive rehabilitation may have a considerable impact on functional outcome, especially when patients with neurological d...

Non-invasive brain stimulation (NIBS) techniques are widely used in research settings to investigate brain mechanisms and increasingly being used for treatment purposes. The aim of this study was to systematically identify and review the current literature on NIBS studies of limb praxis and apraxia in healthy subjects and stroke patients with a sco...

Introduction Aphasia is a common language disorder acquired after stroke that reduces the quality of life of affected patients. The impairment is frequently accompanied by a deficit in cognitive functions. The state-of-the-art therapy is speech and language therapy but recent findings highlight positive effects of high-frequency therapy. Telerehabi...

Background: Discharge planning of stroke patients during inpatient neurorehabilitation is often difficult since it depends both on the patient's ability to perform activities of daily living (ADL) and the social context. The aim of this study was to define ADL cut-off scores using the Lucerne ICF-based multidisciplinary observation scale (LIMOS) th...

Background: People with Parkinson's disease (PD) experience not only motor problems but also non-motor problems that seriously impede their daily functioning and quality of life. The current pharmacologic treatment of PD is symptomatic, and alternative rehabilitation treatments, which preferably also have a disease-modifying effect and promote neur...

Cognitive estimation is a mental ability applied to solve numerical problems when precise facts are unknown, unavailable or impractical to calculate. It has been associated with several underlying cognitive components, most often with executive functions and semantic memory. Little is known about the neural correlates of cognitive estimation. To ad...

Background Gestures are an important part of communication. Patients with schizophrenia present gesture deficits that tend to deteriorate in the course of the disease and hamper functional outcome. This gesture deficit has been associated with motor abnormalities, cognitive impairment, and psychotic symptoms. Unaffected, first-degree relatives of s...

Hand gestures are an integral part of social interactions and communication. Several imaging studies in healthy subjects and lesion studies in patients with apraxia suggest the praxis network for gesture production, involving mainly left inferior frontal, posterior parietal and temporal regions. However, little is known about the structural connect...

Neglect after stroke is most accurately diagnosed by a systematic, ecological observation during everyday behaviour using the Catherine Bergego Scale (CBS). However, the CBS is time-consuming and often omitted in clinical settings, especially stroke units. In this study, we aimed to explore if video-oculography during free visual exploration (FVE),...

There is currently a need for engaging, user-friendly, and repeatable tasks for assessment of cognitive and motor function in aging and neurodegenerative diseases. This study evaluated the feasibility of a maze-like Numberlink puzzle game in assessing differences in game-based measures of cognition and motor function due to age and neurodegenerativ...

Background: We developed a standardized, comprehensive, ambulatory, hospital-based neu- rorehabilitation program ("MS-Fit") to improve disability, activities of daily living and quality of life in people with multiple sclerosis (PwMS). Aim: To assess feasibility, adherence and satisfaction of the training intervention. Design: Prospective mult...

Patients with schizophrenia frequently present deficits in gesture production and interpretation, greatly affecting their communication skills. As these gesture deficits can be found early in the course of illness and as they can predict later outcomes, exploring their neural basis may lead to a better understanding of schizophrenia. While gesturin...

BACKGROUND Persons with Multiple Sclerosis (MS) often experience dexterous difficulties during the performance of activities of daily living, such as fastening buttons, handling coins or writing, impacting, therefore, the health-related quality of life. Mobile Health (mHealth) solutions, such as tablet apps may be used to train impaired dexterous s...

Background: Persons with multiple sclerosis (MS) often experience dexterous difficulties during the performance of activities of daily living, such as fastening buttons, handling coins, or writing, therefore impacting their health-related quality of life. Mobile health (mHealth) solutions, such as tablet apps, may be used to train impaired dextero...

E-presentation about our paper "Eyetracking during free visual exploration detects neglect more reliably than paper-pencil tests" https://doi.org/10.1016/j.cortex.2020.04.021

Background: Imaging studies point to a posture (finger vs. hand) and domain-specific neural basis of gestures. Furthermore, modulation of gestures by theta burst stimulation (TBS) may depend on interhemispheric disinhibition. Objective/hypothesis: In this randomized sham-controlled study, we hypothesized that dual site continuous TBS over left i...

Parkinson’s disease (PD) is characterized by a highly individual disease-profile as well as fluctuating symptoms. Consequently, 24-h home monitoring in a real-world environment would be an ideal solution for precise symptom diagnostics. In recent years, small lightweight sensors which have assisted in objective, reliable analysis of motor symptoms...

Neurorehabilitation is a rapidly developing subspecialty of neurology due to medical advances and growing knowledge on functional recovery from brain injury such as plasticity and regeneration in the nervous system. Furthermore, progress in modern technologies facilitate new therapeutic concepts. Patient-tailored, flexible multimodal neurorehabilit...

Background and purpose: Many individuals with Parkinson disease (PD) suffer from impaired dexterity, which impacts activities of daily living and quality of life. Exergaming, video game-based training with augmented virtual reality, may have value for improving function. The aim of the present pilot study was to comprehensively evaluate the feasib...

Background: Exercise therapy in people with multiple sclerosis (MS) can improve strength, aerobic capacity, fatigue, balance and manual dexterity. Circuit training has been shown to be an effective exercise intervention in several neurological diseases, though it has been poorly investigated in people with MS. So far, a few small trials reported pr...

Die Neuroreha von Patienten nach Schlaganfall muss zielgerichtet und individuell sein. Ein Team am Luzerner Kantonsspital entwickelte deshalb LIMOS, eine Beobachtungsskala, mit der sich Aktivitäts- und Partizipationsfähigkeit von Patienten untersuchen und Therapieschwerpunkte ableiten lassen.

Objective: To establish Rasch validation of the Lucerne International Classification of Functioning, Disability and Health (ICF)-based Multidisciplinary Observation Scale (LIMOS) in stroke. LIMOS measures the level of assistance in daily life activities related to motor function, communication, cognition, and domestic life. Rasch Measurement Theor...

Spatial neglect is a strong and negative predictor of general functional outcome after stroke, and its therapy remains a challenge. Whereas inhibitory non-invasive brain stimulation over the contralesional, intact hemisphere has generally been shown to ameliorate neglect on a group level, a conspicuous variability of the effects at the individual l...

Introduction: Patients with Multiple Sclerosis exhibit disturbed dexterity, leading to difficulties in fine motor skills such as buttoning a T-shirt or hand-writing. Consequently, activities of daily living and quality of life are affected. The aim of the present study is to investigate the effectiveness of a tablet app-based home-based training in...

Die Neuroreha von Patienten nach Schlaganfall muss zielgerichtet und individuell sein. Ein Team am Luzerner Kantonsspital entwickelte deshalb LIMOS, eine Beobachtungsskala, mit der sich Aktivitäts- und Partizipationsfähigkeit von Patienten untersuchen und Therapieschwerpunkte ableiten lassen.

The aim of the present review is to investigate the cerebral correlates, more particularly the role of the parietal lobe, when imitating intransitive gestures, a task highly sensitive to apraxic errors. By providing an integrative review of functional imaging and brain lesion studies, we focused our attention on the meaning of gestures (meaningful...

Parkinson's disease (PD) patients frequently suffer from limb kinetic apraxia (LKA) affecting quality of life. LKA denotes an impairment of precise and independent finger movements beyond bradykinesia, which is reliably assessed by coin rotation (CR) task. BOLD fMRI detected activation of a left inferior parietal‐premotor praxis network in PD durin...

Background Hand gestures are an integral part of social interactions and are involved in nonverbal and verbal communication. The convey language that is expressed by motor actions, and thus depend on the interplay of various brain regions. Several functional magnetic resonance imaging studies in healthy subjects suggest the praxis network for gestu...

Deficient inhibitory control leading to perseverative behaviour is often observed in neglect patients. Previous studies investigating the relationship between response inhibition and visual attention have reported contradictory results: some studies found a linear relationship between neglect severity and perseverative behaviour whereas others coul...

Background Impaired dexterity is a common symptom in Parkinson's disease (PD) and has been related to limb kinetic apraxia (LKA). LKA negatively influenced activities of daily living (ADL) in PD. However, the impact on quality of life (QoL) remains to be clarified, which was the aim of the current study. Methods Eighty nondemented patients with PD...

Introduction Une évaluation des capacités des patients qui ont subi un accident vasculaire cérébral (AVC) alors qu’ils vaquent à leurs activités quotidiennes est très importante afin de planifier une réadaptation ciblée. Des instruments suffisamment sensibles pour pouvoir démontrer les modifications des capacités d’un patient font défaut en pratiqu...

Background Approximately 70–80% of stroke survivors have limited activities of daily living, mainly due to dexterous problems. Videogame-based training (VBT) along with virtual reality seems to be beneficial to train upper limb function.Objective To evaluate the usability of VBT using the Leap Motion Controller (LMC) to train fine manual dexterity...

Schizophrenia is characterized by deficits in gesturing that is important for nonverbal communication. Research in healthy participants and brain-damaged patients revealed a left-lateralized fronto-parieto-temporal network underlying gesture performance. First evidence from structural imaging studies in schizophrenia corroborates these results. How...

Deficient inhibitory control leading to perseverative behaviour is often observed in neglect patients. Previous studies investigating the relationship between response inhibition and visual attention have reported contradictory results: some studies found a linear relationship between neglect severity and perseverative behaviour whereas others coul...

In stroke patients, the clinical presentation of visual field defects (VFDs) is frequently accompanied by visual neglect, i.e., the inability to attend and respond to the contralesional space. However, the diagnostic discrimination between the lack of reactions to contralesional stimuli due to VFDs or visual neglect is challenging during clinical e...

Supplementary material

Schizophrenia patients present with a variety of impaired nonverbal communication skills. Performance of hand gestures is frequently impaired and associated with ratings of motor abnormalities. However, the impact of motor abnormalities to gesture performance remains unclear. To test the association between quantitative measures of motor behavior a...

Parkinson's disease (PD) patients frequently suffer from dexterous deficits impeding activities of daily living. There is controversy whether impaired fine motor skill may stem from limb kinetic apraxia (LKA) rather than bradykinesia. Based on classical models of limb praxis LKA is thought to result when premotor transmission of time-space informat...

Background and purpose: Motor tests performed at stroke onset have been shown to predict the recovery of upper limb motor impairment. Less is known about upper limb recovery at the level of functional activity or of participation and how spatial neglect may influence the integration of the upper limb in the activities of daily living (ADL). Our ob...

Schizophrenia is characterized by social interaction deficits contributing to poor functional outcome. Hand gesture use is particularly impaired, linked to frontal lobe dysfunction and frontal grey matter deficits. The functional neural correlates of impaired gesturing are currently unclear. We therefore investigated aberrant brain activity during...

Dorsal pre-motor cortex (PMd) is thought to play a role in fine motor control. The aim of the present study was to investigate whether inhibitory or excitatory stimulation of PMd would have an impact on manual dexterity in Parkinson’s disease (PD). Fifteen patients with PD participated in this study. High resolution structural MRI was used for neur...

Background: Patients with Parkinson's disease exhibit disturbed dexterity. Validated self-reported outcomes for dexterity in Parkinson's disease are lacking. The aim of this study was to investigate the reliability, content and construct validity of a new Dexterity Questionnaire 24. Methods: One hundred and three patients with Parkinson's diseas...

Background Good responsive functional outcome measures are important to measure change in stroke patients. The aim of study was to compare the internal and external responsiveness, floor and ceiling effects of the motor, cognition, and communication subscales of the Lucerne ICF-based Multidisciplinary Observation Scale (LIMOS) with the motor and co...

The functional outcome of schizophrenia is heterogeneous and markers of the course are missing. Functional outcome is associated with social cognition and negative symptoms. Gesture performance and nonverbal social perception are critically impaired in schizophrenia. Here, we tested whether gesture performance or nonverbal social perception could p...

Supplementary material.