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Case Reports
. 2023 Feb;13(1):e200112.
doi: 10.1212/CPJ.0000000000200112. Epub 2023 Jan 13.

Sequential Gaze-Shifting Approach to Reconstruct Self-portrait and Daily Activities in Hemispatial Neglect After Stroke: A Case Report

Shigetoshi Takaya  1 , Takayuki Kato  1
Affiliations
Case Reports

Sequential Gaze-Shifting Approach to Reconstruct Self-portrait and Daily Activities in Hemispatial Neglect After Stroke: A Case Report

Shigetoshi Takaya et al. Neurol Clin Pract. 2023 Feb.

Abstract

Objectives: The aim of this study was to demonstrate the use of a sequential gaze-shifting approach to complete a self-portrait in a patient with hemispatial neglect after stroke as a means of rehabilitation to restore skills to perform activities of daily living (ADL).

Methods: This case report describes a 71-year-old amateur painter who presented with severe left hemispatial neglect after stroke. Initially, he drew self-portraits omitting the left side. Six months poststroke, the patient was able to complete well-composed self-portraits by sequentially shifting his gaze and intentionally directing his visual attention from the right non-neglected space to the left neglected space. Then the patient was instructed to repeatedly practice a serial movement of each ADL using this sequential gaze-shifting technique.

Results: Seven months poststroke, the patient achieved independence in ADL such as dressing the upper body, grooming, eating, and toileting although moderate hemispatial neglect and hemiparesis were still present.

Discussion: The effects of existing rehabilitation approaches can be difficult to generalize and apply to the performance of each individual ADL in patients with hemispatial neglect after stroke. Sequential gaze shifting may be a viable compensation strategy in directing attention to the neglected space and restoring the ability to perform each ADL.

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Figures

Figure 1
Figure 1. Brain CT at 6 Weeks Poststroke
Figure 2
Figure 2. Changes in Self-Portrait
Self-portraits before (A) and at 2 (B), 3 (C), 5 (D), and 6 (E) months after stroke. A series of photographs showing the patient drawing a self-portrait sequentially from right to left 6 months after stroke (F–J and E).
Figure 3
Figure 3. Schema of the Sequential Gaze-Shifting Approach to Dress the Upper Body
(A) Placing the shirt on the lap or table in the non-neglected right space. (B) Positioning the shirt with the collar away from the body with the inside facing up. Finding the left sleeve of the shirt and unfolding it toward the right. Then, finding the right sleeve, spreading it out toward the neglected left space, and getting an overall view of the shirt from right to left. (C) Grabbing the armhole of the left sleeve with the right hand in the right space; while sequentially shifting gaze from the right to median to left, bringing the armhole to the left space while exploring the left hand, and finally passing the left hand through the armhole. (D) While sequentially shifting gaze toward the outer left, moving the armhole from the left wrist to the elbow and up to the shoulder. (E–G) While shifting the gaze from the left to median to right, passing the right hand through the right sleeve.
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References

    1. Crutch SJ, Isaacs R, Rossor MN. Some workmen can blame their tools: artistic change in an individual with Alzheimer's disease. Lancet. 2001;357(9274):2129-2133. doi: 10.1016/s0140-6736(00)05187-4. - DOI - PubMed
    1. Blanke O. I and me: self-portraiture in brain damage. In: Bogousslavsky J, Hennerici MG, eds. Front Neurol Neurosci–Neurological Disorders in Famous Artists Part 2: Karger; 2007:14-29. - PubMed
    1. Luauté J, Halligan P, Rode G, Rossetti Y, Boisson D. Visuo-spatial neglect: a systematic review of current interventions and their effectiveness. Neurosci Biobehav Rev. 2006;30(7):961-982. doi: 10.1016/j.neubiorev.2006.03.001. - DOI - PubMed
    1. Spaccavento S, Cellamare F, Cafforio E, Loverre A, Craca A. Efficacy of visual-scanning training and prism adaptation for neglect rehabilitation. Appl Neuropsychol Adult. 2016;23(5):313-321. doi: 10.1080/23279095.2015.1038386. - DOI - PubMed
    1. Corbetta M, Shulman GL. Spatial neglect and attention networks. Annu Rev Neurosci. 2011;34(1):569-599. doi: 10.1146/annurev-neuro-061010-113731. - DOI - PMC - PubMed

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