Pharmacological Treatment of Visuospatial Neglect: A Systematic Review

Kemp, Jet van der; Dorresteijn, M.; Brink, Antonia F. Ten; Nijboer, Tanja C.W.; Visser-Meily, Johanna M A

doi:10.1016/j.jstrokecerebrovasdis.2017.02.012

Cited by 13 publications

(4 citation statements)

References 65 publications

(185 reference statements)

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“…Results in humans have been mixed but, given to the responsive patient populations, this may be a powerful adjunct to physical therapy. Although beyond the scope of this review, there is also evidence that DA-based pharmacotherapy may be beneficial in aphasia (Gill and Leff, 2012 ), hemi-spatial neglect (van der Kemp et al, 2017 ), and poststroke depression (Kohno et al, 2010 ; Delbari et al, 2011 ; Adam et al, 2013 ; Spiegel and Chatterjee, 2014 ; Stanfill et al, 2016 ). Meanwhile, like the findings for DA-based pharmacotherapies in motor recovery, results in these areas are quite mixed.…”

Section: Discussionmentioning

confidence: 99%

The Intersection of Central Dopamine System and Stroke: Potential Avenues Aiming at Enhancement of Motor Recovery

Gower

Tiberi

2018

Front. Synaptic Neurosci.

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Dopamine, a major neurotransmitter, plays a role in a wide range of brain sensorimotor functions. Parkinson's disease and schizophrenia are two major human neuropsychiatric disorders typically associated with dysfunctional dopamine activity levels, which can be alleviated through the druggability of the dopaminergic systems. Meanwhile, several studies suggest that optimal brain dopamine activity levels are also significantly impacted in other serious neurological conditions, notably stroke, but this has yet to be fully appreciated at both basic and clinical research levels. This is of utmost importance as there is a need for better treatments to improve recovery from stroke. Here, we discuss the state of knowledge regarding the modulation of dopaminergic systems following stroke, and the use of dopamine boosting therapies in animal stroke models to improve stroke recovery. Indeed, studies in animals and humans show stroke leads to changes in dopamine functioning. Moreover, evidence from animal stroke models suggests stimulation of dopamine receptors may be a promising therapeutic approach for enhancing motor recovery from stroke. With respect to the latter, we discuss the evidence for several possible receptor-linked mechanisms by which improved motor recovery may be mediated. One avenue of particular promise is the subtype-selective stimulation of dopamine receptors in conjunction with physical therapy. However, results from clinical trials so far have been more mixed due to a number of potential reasons including, targeting of the wrong patient populations and use of drugs which modulate a wide array of receptors. Notwithstanding these issues, it is hoped that future research endeavors will assist in the development of more refined dopaminergic therapeutic approaches to enhance stroke recovery.

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Section: Discussionmentioning

confidence: 99%

The Intersection of Central Dopamine System and Stroke: Potential Avenues Aiming at Enhancement of Motor Recovery

Gower

Tiberi

2018

Front. Synaptic Neurosci.

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“…Pharmacological interventions continue to be considered for the treatment of inattention, particularly cholinergic therapies, such as rivastigmine [ 65 , 66 ], though there is a marked absence of double-blind, randomized clinical trials. Presently, clinical trials targeting general cognitive improvement are underway using levodopa (NCT03735901) and maraviroc (NCT04966429), and rolflumilast is under investigation specifically for treating post-stroke memory impairment (NCT04854811).…”

Section: Cognition and Memorymentioning

confidence: 99%

Reversing the Ruin: Rehabilitation, Recovery, and Restoration After Stroke

Stockbridge

Bunker

Hillis

2022

Curr Neurol Neurosci Rep

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Purpose of Review Stroke is a common cause of disability in aging adults. A given individual’s needs after stroke vary as a function of the stroke extent and location. The purpose of this review was to discuss recent clinical investigations addressing rehabilitation of an array of overlapping functional domains. Recent Findings Research is ongoing in the domains of movement, cognition, attention, speech, language, swallowing, and mental health. To best assist patients’ recovery, innovative research has sought to develop and evaluate behavioral approaches, identify and refine synergistic approaches that augment the response to behavioral therapy, and integrate technology where appropriate, particularly to introduce and titrate real-world complexity and improve the overall experience of therapy. Summary Recent and ongoing trials have increasingly adopted a multidisciplinary nature — augmenting refined behavioral therapy approaches with methods for increasing their potency, such as pharmaceutical or electrical interventions. The integration of virtual reality, robotics, and other technological advancements has generated immense excitement, but has not resulted in consistent improvements over more universally accessible, lower technology therapy.

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“…Other pharmacological approaches include noradrenergic agents (Malhotra, Parton, Greenwood, & Husain, 2006) and pro-cholinergic drugs (Thiel, Zilles, & Fink, 2005). To date, no valid conclusions can be drawn and pharmacological treatment is usually not part of the rehabilitative strategy (van der Kemp, Dorresteijn, Ten Brink, Nijboer, & Visser-Meily, 2017).…”

Section: Therapymentioning

confidence: 99%

Visuospatial Neglect - a Theory-Informed Overview of Current and Emerging Strategies and a Systematic Review on the Therapeutic Use of Non-invasive Brain Stimulation

2019

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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.

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Pharmacological Treatment of Visuospatial Neglect: A Systematic Review

Cited by 13 publications

References 65 publications

The Intersection of Central Dopamine System and Stroke: Potential Avenues Aiming at Enhancement of Motor Recovery

The Intersection of Central Dopamine System and Stroke: Potential Avenues Aiming at Enhancement of Motor Recovery

Reversing the Ruin: Rehabilitation, Recovery, and Restoration After Stroke

Visuospatial Neglect - a Theory-Informed Overview of Current and Emerging Strategies and a Systematic Review on the Therapeutic Use of Non-invasive Brain Stimulation

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