Citations
Citations
To examine whether transcranial direct current stimulation (tDCS) applied over the posterior parietal cortex (PPC) improves visuospatial attention in stroke patients with left visuospatial neglect.
Patients were randomly assigned to 1 of 3 treatment groups: anodal tDCS over the right PPC, cathodal tDCS over the left PPC, or sham tDCS. Each patient underwent 15 sessions of tDCS (5 sessions per week for 3 weeks; 2 mA for 30 minutes in each session). Outcome measures were assessed before treatment and 1 week after completing the treatment.
From pre- to post-treatment, there was an improvement in the motor-free visual perception test (MVPT), line bisection test (LBT), star cancellation test (SCT), Catherine Bergego Scale (CBS), Korean version of Modified Barthel Index (K-MBI), and Functional Ambulation Classification in all 3 groups. Improvements in the MVPT, SCT, and LBT were greater in the anodal and cathodal groups than in the sham group. However, improvements in other outcomes were not significantly different between the 3 groups, although there was a tendency for improved CBS or K-MBI scores in the anodal and cathodal groups, as compared with the sham group.
The study results indicated that the facilitatory effect of anodal tDCS applied over the right PPC, and the inhibitory effect of cathodal tDCS applied over the left PPC, improved symptoms of visuospatial neglect. Thus, tDCS could be a successful adjuvant therapeutic modality to recover neglect symptom, but this recovery might not lead to improvements in activities of daily living function and gait function.
Citations
To investigate the correlation between visuospatial neglect and anemia in patients with right cerebral infarction, as well as to identify the risk factor of neglect and furnish preliminary data on rehabilitation management.
The line bisection test and Albert test were conducted on subjects with right cerebral infarction in order to analyze neglect severity. Multiple linear regression analysis was conducted to investigate correlation between neglect severity and hemoglobin and hematocrit level. Logistic regression analysis was applied to identify the risk factor of neglect.
Visuospatial neglect was observed in 33 subjects out of 124. Hemoglobin and hematocrit were not directly correlated with visuospatial neglect severity, whereas infarct size was directly correlated. Subjects with visuospatial neglect were characterized by a large infarct size, a low score in the Mini-Mental State Examination and long hospital stay.
In this study, visuospatial neglect was found to be uncorrelated with anemia. It implies that emphasis should be placed on the early detection of anemia and neglect in patients with left hemiplegia, the formulation of respective therapeutic plans and improvement of prognosis. The study found that the possibility of a visuospatial neglect occurrence increases with infarct size. In this regard, it is required that visuospatial neglect was detected and treated in the earliest possible stage, notwithstanding the difficulty that lies in the precise measurement of the severity.
To investigate the effect of virtual reality training on unilateral spatial neglect in stroke patients.
Twenty-four stroke patients (14 males and 10 females, mean age=64.7) who had unilateral spatial neglect as a result of right hemisphere stroke were recruited. All patients were randomly assigned to either the virtual reality (VR) group (n=12) or the control group (n=12). The VR group received VR training, which stimulated the left side of their bodies. The control group received conventional neglect therapy such as visual scanning training. Both groups received therapy for 30 minutes a day, five days per week for three weeks. Outcome measurements included star cancellation test, line bisection test, Catherine Bergego scale (CBS), and the Korean version of modified Barthel index (K-MBI). These measurements were taken before and after treatment.
There were no significant differences in the baseline characteristics and initial values between the two groups. The changes in star cancellation test results and CBS in the VR group were significantly higher than those of the control group after treatment. The changes in line bisection test score and the K-MBI in the VR group were not statistically significant.
This study suggests that virtual reality training may be a beneficial therapeutic technique on unilateral spatial neglect in stroke patients.
Citations
Objective: To investigate the effect of the prism which deviates the optical axis 10 degree rightward in the stroke patients who have visuospatial neglect and to evaluate how long it will last.
Method: The subjects were 9 left hemiplegic patients who showed the feature of hemineglect. The prism goggle was applied and the patients were trained the midline point direction exercise. It's effect was evaluated by the line bisection test and the Albert test at the pre-training, immediate, 2 hours and 6 hours after the training respectively.
Results: The line bisection test and Albert test were not improved significantly at each evaluation time after the training.
Conclusion: This result revealed the prism therapy does not have a significant effect on the line bisection task and Albert test in the hemineglect patients consistently. The line bisection result in the line located in the left or right side at the 2 hours after the training was improved but it could not exclude the training effect of the repetition of the test.
Objective: To confirm the merit of a newly-developed computer system that detects gaze in diagnosing unilateral visual neglect syndrome.
Method: The subjects were 20 normal adults and 2 left hemiplegic patients with prominent unilateral visual neglect. The 'line bisection' test and the 'star cancellation' test were performed, and their modified forms of tests-the 'center scanning in vacant 2-dimension space' and the 'one object scanning' among 25 different objects were also performed on a table with right hand and on a computer monitor with head motion.
Results: Normal subjects didn't show difference in line bisection and center scanning tests. However, center scanning time was shorter in the methods that used a computer. By comparing horizontal shifting in the line bisection test and the center scanning test, the center was more shifted toward left side than in the line bisection test when the tests were performed using a computer. Duration to perform the star cancellation was longer than to perform the one object scanning test. It took 3 minutes for each subject to obtain the results from the line bisection and the center scanning on papers, whereas the results from the tests with a computer were displayed at the moment of marking by the subjects. By the results from the patients, the marked centers were deviated toward right side and longer duration was needed to perform the tests in comparison with normal subjects.
Conclusion: Visual perception can be changed by dimension even in normal adults, and the program using a computer that was developed in this study has merit especially by shortening the testing time. However, continuous study is needed for practical use of this program in the patients with unilateral neglect.
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