<p>Unilateral Spatial Neglect After Stroke: Current Insights</p>

Abstract

Introduction: Unilateral spatial neglect (USN) is a disorder of contralesional space awareness which often follows unilateral brain lesion. Since USN impairs awareness of contralesional space/body and often of concomitant motor disorders, its presence represents a negative prognostic factor of functional recovery. Thus, the disorder needs to be carefully diagnosed and treated. Here, we attempted to present a clear and concise picture of current insights in the comprehension and rehabilitation of USN. Methods: We first provided an updated overview of USN clinical and neuroanatomical features and then highlighted recent progresses in the diagnosis and rehabilitation of the disease. In relation to USN rehabilitation, we conducted a MEDLINE literature research on three of the most promising interventions for USN rehabilitation: prismatic adaptation (PA), non-invasive brain stimulation (NIBS), and virtual reality (VR). The identified studies were classified according to the strength of their methods. Results: The last years have witnessed a relative decrement of interest in the study of neuropsychological disorders of spatial awareness in USN, but a relative increase in the study of potential interventions for its rehabilitation. Although optimal protocols still need to be defined, high-quality studies have demonstrated the efficacy of PA, TMS and tDCS interventions for the treatment of USN. In addition, preliminary investigations are suggesting the potentials of GVS and VR approaches for USN rehabilitation. Conclusion: Advancing neuropsychological and neuroscience tools to investigate USN pathophysiology is a necessary step to identify effective rehabilitation treatments and to foster our understanding of neurofunctional bases of spatial cognition in the healthy brain.

EEG Theta Power Activity Reflects Workload among Army Combat Drivers: An Experimental Study

“…Here, we found that an increase in the θ-activity occurred predominantly in the right frontal electrodes (i.e., frontal θ-asymmetry). We can speculate that, since the right hemisphere is related to spatial functions (i.e., it would be dominant or specialized for the processing of visuo-spatial tasks), it would be more involved in the kind of tasks participants carry out during driving simulations [74]. Although this study was not designed to specifically investigate the topographical distribution of the θ-activity, previous studies have found hemispheric asymmetries in EEG depending on the workload demands, and it seems that such asymmetry depends on the task nature (e.g., [75]).…”

Unilateral spatial neglect

“…1 2 In the acute phase, the patient may show an ipsilesional deviation of the head and eyes. 3 The damaged lesion is typically located in the inferior parietal lobule region, as in this case. Patients who present with behavioural abnormalities are challenging to examine, but an astute observation on the deviation of the head and eyes may lead to a rapid and accurate diagnosis.…”

Applications of Functional Magnetic Resonance Imaging in Determining the Pathophysiological Mechanisms and Rehabilitation of Spatial Neglect

“…Consensus on the most efficacious therapy for SN is lacking. However, several promising interventions have been proposed to improve SN symptoms: prismatic adaptation (PA), non-invasive brain stimulation (NIBS), motor imagery (MI), optokinetic stimulation (OKS) and virtual reality (VR) ( 61 – 76 ). Besides, there is a low level of evidence in favor of mirror therapy, neck-muscle vibration, family involvement, motor activation and spatial cueing for SN ( 77 ).…”

“…Top–down methods are based on a voluntary effort of the patient following a therapist's instructions, such as MI ( 77 ). Bottom–up methods are based on the patient's sensory environment or visuomotor adaptation, such as PA and OKS ( 61 , 71 ). NIBS–TMS and transcranial direct current stimulation (tDCS), which were developed on a model of interhemispheric competition, can also ameliorate the behavioral deficits of SN by reducing the activity of the unaffected hemisphere or by increasing the activity of the affected hemisphere ( 78 , 79 ).…”