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Unilateral Spatial Neglect After Stroke: Current Insights

Authors Gammeri R, Iacono C, Ricci R, Salatino A

Received 10 August 2019

Accepted for publication 24 December 2019

Published 10 January 2020 Volume 2020:16 Pages 131—152

DOI https://doi.org/10.2147/NDT.S171461

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder


Roberto Gammeri, 1 Claudio Iacono, 1 Raffaella Ricci, 1, 2 Adriana Salatino 1

1Department of Psychology, SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, University of Turin, Turin, Italy; 2Neuroscience Institute of Turin (NIT), University of Turin, Turin, Italy

Correspondence: Raffaella Ricci; Adriana Salatino
Department of Psychology, Via Verdi, 10, Turin 10124, Italy
Tel +39 0116702057
Email raffaella.ricci@unito.it; adriana.salatino@unito.it

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.

Keywords: unilateral spatial neglect, rehabilitation, spatial attention, stroke

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