ABSTRACT

Unilateral spatial neglect (USN) is a neuropsychological syndrome, typically caused by lesions of the right hemisphere, whose features are the defective report of events occurring in the left (contralesional) side of space and the inability to orient and set up actions leftwards. Multisensory integration mechanisms, largely spared in USN patients, may temporally modulate spatial orienting. In this pilot study, the effects of an intensive audio-visual Multisensory Stimulation (MS) on USN were assessed, and compared with those of a treatment that ameliorates USN, Prismatic Adaptation (PA). Twenty USN stroke patients received a 2-week treatment (20 sessions, twice per day) of MS or PA. The effects of MS and PA were assessed by a set of neuropsychological clinical tests (target cancellation, line bisection, sentence reading, personal neglect, complex drawing) and the Catherine Bergego Scale for functional disability. Results showed that MS brought about an amelioration of USN deficits overall comparable to that induced by PA; personal neglect was improved only by MS, not by PA. The clinical gains of the MS treatment were not influenced by duration of disease and lesion volume, and they persisted up to one month post-treatment. In conclusion, MS represents a novel and promising rehabilitation procedure for USN.

摘要

单侧空间忽视 (USN) 是一种神经心理综合征，通常由右半球病变引起，其特征是空间左侧（对侧）发生的事件报告有缺陷，无法向左定向和设置动作。多感官整合机制，在 USN 患者中很大程度上幸免于难，可能会在时间上调节空间定向。在这项试点研究中，评估了强化视听多感觉刺激 (MS) 对 USN 的影响，并与改善 USN 的治疗方法（棱镜适应 (PA)）进行了比较。20 名 USN 中风患者接受了为期 2 周的 MS 或 PA 治疗（20 次，每天两次）。MS 和 PA 的影响通过一组神经心理学临床测试（目标取消、线平分、句子阅读、个人忽视、复杂绘图）和功能性残疾的 Catherine Bergego 量表。结果表明，MS 对 USN 缺陷的总体改善与 PA 诱导的改善相当；只有 MS 改善了个人忽视，而不是 PA。MS 治疗的临床获益不受病程和病灶体积的影响，并且在治疗后持续长达 1 个月。总之，MS 代表了一种新颖且有前途的 USN 康复程序。