Visuospatial neglect constitutes a supramodal cognitive deficit characterized by reduction or loss of spatial awareness for the contralesional space. It occurs in over 40% of right- and 20% of left-brain-lesioned stroke patients with lesions located mostly in parietal, frontal and subcortical brain areas. Visuospatial neglect is a multifaceted syndrome - symptoms can be divided into sensory, motor and representational neglect - and therefore requires an individually adapted diagnostic and therapeutic approach. Several models try to explain the origins of visuospatial neglect, of which the “interhemispheric rivalry model” is strongly supported by animal and human research. This model proposes that allocation of spatial attention is balanced by transcallosal inhibition and both hemispheres compete to direct attention to the contralateral hemi-space. Accordingly, a brain lesion causes an interhemispheric imbalance, which may be re-installed by activation of lesioned, or deactivation of unlesioned (over-activated) brain areas through noninvasive brain stimulation. Research in larger patient samples is needed to confirm whether noninvasive brain stimulation can improve long-term outcomes and whether these also affect activities of daily living and discharge destination.

中文翻译：

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视觉空间忽视 - 当前和新兴策略的理论概述以及对非侵入性脑刺激治疗用途的系统回顾。


视觉空间忽视构成一种超模态认知缺陷，其特征是对侧空间的空间意识减少或丧失。超过 40% 的右脑损伤和 20% 的左脑损伤中风患者会发生这种情况，损伤主要位于顶叶、额叶和皮质下脑区域。视觉空间忽视是一种多方面的综合症——症状可分为感觉、运动和表征忽视——因此需要个体化的诊断和治疗方法。一些模型试图解释视觉空间忽视的起源，其中“半球间竞争模型”得到了动物和人类研究的大力支持。该模型提出，空间注意力的分配通过胼胝体抑制来平衡，并且两个半球竞争将注意力引导到对侧半空间。因此，大脑损伤会导致半球间不平衡，这种不平衡可以通过非侵入性脑刺激激活损伤的大脑区域或停用未损伤（过度激活）的大脑区域来重新安装。需要对更大的患者样本进行研究，以确认无创脑刺激是否可以改善长期结果，以及这些是否也会影响日常生活活动和出院目的地。