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Randomized Controlled Trial
. 2020 Jan;30(1):32-53.
doi: 10.1080/09602011.2018.1448287. Epub 2018 Mar 20.

Frontal lesions predict response to prism adaptation treatment in spatial neglect: A randomised controlled study

Kelly M Goedert  1 , Peii Chen  2   3 , Anne L Foundas  4 , A M Barrett  2   3
Affiliations
Randomized Controlled Trial

Frontal lesions predict response to prism adaptation treatment in spatial neglect: A randomised controlled study

Kelly M Goedert et al. Neuropsychol Rehabil. 2020 Jan.

Abstract

Spatial neglect commonly follows right hemisphere stroke. It is defined as impaired contralesional stimulus detection, response, or action, causing functional disability. While prism adaptation treatment is highly promising to promote functional recovery of spatial neglect, not all individuals respond. Consistent with a primary effect of prism adaptation on spatial movements, we previously demonstrated that functional improvement after prism adaptation treatment is linked to frontal lobe lesions. However, that study was a treatment-only study with no randomised control group. The current study randomised individuals with spatial neglect to receive 10 days of prism adaptation treatment or to receive only standard care (control group). Replicating our earlier results, we found that the presence of frontal lesions moderated response to prism adaptation treatment: among prism-treated patients, only those with frontal lesions demonstrated functional improvements in their neglect symptoms. Conversely, among individuals in the standard care control group, the presence of frontal lesions did not modify recovery. These results suggest that further research is needed on how frontal lesions may predict response to prism adaptation treatment. Additionally, the results help elucidate the neural network involved in spatial movement and could be used to aid decisions about treatment.

Keywords: Lesion mapping; Prism adaptation; Rehabilitation; Spatial neglect; Stroke.

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Conflict of interest statement

Disclosure of Interest

Authors Goedert, and Foundas report no conflicts of interest. Drs. Chen and Barrett report the scientific funding disclosed above, and are both employees of the Kessler Foundation.

Figures

Figure 1.
Figure 1.
Prism adaptation treatment administration using the Kessler Foundation Prism Adaptation Treatment (KF-PAT) Portable Kit, patent pending.
Figure 2.
Figure 2.
Enrollment, treatment, and weekly assessment timeline. S = screening.
Figure 3.
Figure 3.
Image overlaps for the control and prism-treated groups. Images are displayed in radiological convention (the left side of the image shows the right side of the brain).
Figure 4.
Figure 4.
CBS recovery trajectories, including influential case indicated by * in control + no frontal lesion group (upper left panel). Removal of influential case leads to a flat slope in that group, b = −0.43, SE = 0.57, p = .453.
See this image and copyright information in PMC

References

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