ABSTRACT

Prismatic adaptation (PA) with wedge prisms is a non-invasive technique used in the rehabilitation of patients suffering from spatial neglect. Unfortunately, as for many behavioural intervention techniques, it is nearly impossible to achieve adequate blinding using wedge prisms, and the potential benefit of PA in the rehabilitation of neglect remains controversial. In order to study an alternative to wedge prism, we examine whether virtual PA at different degrees of deviation may alleviate signs of neglect in a double-blind design. Fifteen neglect patients participated in three adaptation sessions, which differed by the degree of deviation (0°, 15°, or 30°). Performance in line bisection and item cancellation tasks was measured in virtual reality immediately before and after adaptation. Session allocation was concealed from patients and the examiner. Despite the presence of robust, dose-dependent effects of virtual PA on Open-Loop Pointing (OLP), no transfer to line bisection and item cancellation tests were observed. None of the patients were aware of differences between sessions. Virtual PA did not result in visuo-motor transfer effects despite inducing significant adaptation effects in OLP. Together with recent negative findings of randomized-controlled trials, these findings cast doubt on the general efficacy of PA as a rehabilitation method of spatial neglect.

摘要

带楔形棱镜的棱镜适应 (PA) 是一种非侵入性技术，用于空间忽视患者的康复。不幸的是，对于许多行为干预技术，使用楔形棱镜几乎不可能实现足够的致盲，而 PA 在康复忽视中的潜在益处仍然存在争议。为了研究楔形棱镜的替代方案，我们检查了不同偏差程度的虚拟 PA 是否可以减轻双盲设计中的忽视迹象。15 名忽视患者参加了三个适应期，这些适应期因偏离程度（0°、15° 或 30°）而异。在适应前后立即在虚拟现实中测量线平分和项目取消任务的性能。会话分配对患者和检查者隐瞒。尽管虚拟 PA 对开环指向 (OLP) 存在稳健的剂量依赖性影响，但没有观察到转移到线平分和项目取消测试。没有患者意识到会话之间的差异。尽管在 OLP 中诱导了显着的适应效应，但虚拟 PA 并未导致视觉运动转移效应。连同最近随机对照试验的负面结果，这些发现对 PA 作为空间忽视康复方法的一般有效性提出了质疑。尽管在 OLP 中诱导了显着的适应效应，但虚拟 PA 并未导致视觉运动转移效应。连同最近随机对照试验的负面结果，这些发现对 PA 作为空间忽视康复方法的一般有效性提出了质疑。尽管在 OLP 中诱导了显着的适应效应，但虚拟 PA 并未导致视觉运动转移效应。连同最近随机对照试验的负面结果，这些发现对 PA 作为空间忽视康复方法的一般有效性提出了质疑。