Prism adaptation therapy hope for spatial neglect

New York – Spatial neglect, an under-recognised but disabling disorder, often complicates recovery from right brain stroke.

Now there is some hope for such patients as stroke rehabilitation researchers have reported improvement in those suffering from spatial neglect with prism adaptation therapy – used to rehabilitate the visuo-spatial deficits of neurological disorders such as unilateral neglect.

This new study, published in the journal Neurorehabilitation and Neural Repair, supports behavioural classification of patients with spatial neglect as a valuable tool for effective early rehabilitation.

“Our study suggests we need to know what kind of neglect patients have in order to assign treatment,” said A.M. Barrett, director of Stroke Rehabilitation Research at New Jersey-based Kessler Foundation.

The research team tested the hypothesis that classifying patients by their spatial neglect profile — by ‘Where’ (perceptional-intentional) versus ‘Aiming’ (motor-intentional) symptoms — would predict response to prism adaptation therapy.

They hypothesised that patients with ‘Aiming’ bias would have better response to prism adaptation recovery than those with isolated ‘Where’ bias, said the study.

The study involved 24 patients with right brain stroke who completed two weeks of prism adaptation treatment.

Participants also completed the Behavioral Inattention Test and Catherine Bergego Scale (CBS) tests of neglect recovery weekly for six weeks.

Those with only ‘Aiming’ deficits improved on the CBS, whereas those with only ‘Where’ deficits did not improve. Participants with both types of deficits demonstrated intermediate improvement, added the study.

“These findings suggest that patients with spatial neglect and Aiming deficits may benefit the most from early intervention with prism adaptataion therapy,” added Barrett.

More broadly, classifying spatial deficits using modality-specific measures should be an important consideration of any stroke trial intending to obtain the most valid, applicable, and valuable results for recovery after right brain stroke,” said the study.