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. 2014 Sep;8(3):346-58.
doi: 10.1007/s11682-012-9200-5.

Integrity of medial temporal structures may predict better improvement of spatial neglect with prism adaptation treatment

Peii Chen  1 , Kelly M Goedert, Priyanka Shah, Anne L Foundas, A M Barrett
Affiliations

Integrity of medial temporal structures may predict better improvement of spatial neglect with prism adaptation treatment

Peii Chen et al. Brain Imaging Behav. 2014 Sep.

Abstract

Prism adaptation treatment (PAT) is a promising rehabilitative method for functional recovery in persons with spatial neglect. Previous research suggests that PAT improves motor-intentional "aiming" deficits that frequently occur with frontal lesions. To test whether presence of frontal lesions predicted better improvement of spatial neglect after PAT, the current study evaluated neglect-specific improvement in functional activities (assessment with the Catherine Bergego Scale) over time in 21 right-brain-damaged stroke survivors with left-sided spatial neglect. The results demonstrated that neglect patients' functional activities improved after two weeks of PAT and continued improving for four weeks. Such functional improvement did not occur equally in all of the participants: Neglect patients with lesions involving the frontal cortex (n = 13) experienced significantly better functional improvement than did those without frontal lesions (n = 8). More importantly, voxel-based lesion-behavior mapping (VLBM) revealed that in comparison to the group of patients without frontal lesions, the frontal-lesioned neglect patients had intact regions in the medial temporal areas, the superior temporal areas, and the inferior longitudinal fasciculus. The medial cortical and subcortical areas in the temporal lobe were especially distinguished in the "frontal lesion" group. The findings suggest that the integrity of medial temporal structures may play an important role in supporting functional improvement after PAT.

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Figures

Fig. 1
Fig. 1
Study time line. After Assessment 2, the interval between each tick is a week. The gray bar indicates two weeks of the prism adaptation treatment
Fig. 2
Fig. 2
CBS improvement trajectories for participants with and without frontal lesion involvement. Dots are means; error bars are standard errors.
Fig. 3
Fig. 3
Comparison of lesion maps of the “frontal lesion” and “no frontal lesion” groups. The maps are presented with the right hemisphere showing on the left. The number of overlap = 1 is not presented a. Participants with frontal lesion involvement; the “frontal lesion” group (n= 13). b. Participants without frontal lesion involvement; the “no frontal lesion” group (n=8)
Fig. 4
Fig. 4
Result of the voxel-based lesion-behavior mapping (VLBM). The color codes are the z scores that survived the 5 % false discovery rate cut-off threshold. These regions were not only intact in the “frontal” group but also significantly differentiable from the “no-frontal” group. The axial, coronal, and sagittal views of slides a and b (see the upper right corner) are displayed with selected zoom-in images. Abbreviation: FDR, false discovery rate
See this image and copyright information in PMC

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