We conclude that (i) kinaesthetic visuomotor imagery is a feasible technique for sub-acute neglect patients and that (ii) imagery practice leads to improvements in the perception of body and space. Future research is required to specify criteria for indication and contraindication.

INTRODUCTION:Only few studies have investigated the effects of motor imagery training (MIT) on neglect symptoms. OBJECTIVE: To investigate the imagery ability of patients with visuospatial neglect and the behavioral effects of MIT on neglect symptoms. METHODS: In an intense four-week course 10 patients with chronic visuospatial neglect symptoms resulting from righthemisphere lesions practiced MIT by mentally envisaging positions and movements of the contralesional upper limb. Visual and kinesthetic MIT abilities as well as neglect-related disability were evaluated prior to and following therapy. Neglect symptoms were as well assessed at three-month follow-up. RESULTS: Results suggest that (i) the ability to perform motor imagery is principally retained in patients with neglect and even patients that are seemingly incapable of motor imagery are able to relearn imagined activation via an individualized training approach. Furthermore, imagined activation of the left arm (ii) significantly reduces the severity of neglect in exploration, (iii) enhances temporal and spatial orientation, and (iiii) significantly improves the kinesthetic motor-imagery capacity and ability. These improvements were stable over a three-month period, indicating long-term training effects. CONCLUSION: Our data suggest that active kinesthetic-motor imagery is a feasible and effective training method for patients suffering from chronic visuospatial neglect symptoms.

These initial results demonstrate motor imagery capacity in patients with chronic neglect via compensatory neural processing during motor imagery of the affected hand in ipsilateral brain regions, since we found that the supplementary motor area appears to be specifically related to neglect severity. Although our results must be treated with caution due to the small sample size and missing control group, they indicate that neglect is not necessarily an exclusion criterion for motor imagery training per se.