title: Presence of Motor-Intentional Aiming Deficit Predicts Functional Improvement of Spatial Neglect With Prism Adaptation.
abstract: Background Spatial neglect is a debilitating disorder for which there is no agreed on course of rehabilitation. The lack of consensus on treatment may result from systematic differences in the syndrome's characteristics, with spatial cognitive deficits potentially affecting perceptual-attentional "Where" or motor-intentional "Aiming" spatial processing. Heterogeneity of response to treatment might be explained by different treatment impacts on these dissociated deficits: prism adaptation, for example, might reduce Aiming deficits without affecting Where spatial deficits.
  
  
  OBJECTIVE
  Here, we tested the hypothesis that classifying patients by their profile of Where-versus-Aiming spatial deficit would predict response to prism adaptation and specifically that patients with Aiming bias would have better recovery than those with isolated Where bias. Methods We classified the spatial errors of 24 subacute right stroke survivors with left spatial neglect as (1) isolated Where bias, (2) isolated Aiming bias, or (3) both. Participants then completed 2 weeks of prism adaptation treatment. They also completed the Behavioral Inattention Test and Catherine Bergego Scale (CBS) tests of neglect recovery weekly for 6 weeks. Results As hypothesized, participants with only Aiming deficits improved on the CBS, whereas those with only Where deficits did not improve. Participants with both deficits demonstrated intermediate improvement. Conclusion These results support behavioral classification of spatial neglect patients as a potential valuable tool for assigning targeted, effective early rehabilitation.
authors.affiliation: Seton Hall University, South Orange, NJ, USA kelly.goedert@shu.edu.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Goedert
authors.affiliation: Kessler Foundation, West Orange, NJ, USA Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Peii
authors.initials: P
authors.lastname: Chen
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Boston
authors.affiliation: University of Missouri-Kansas City, MO, USA.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Foundas
authors.affiliation: Kessler Foundation, West Orange, NJ, USA Rutgers New Jersey Medical School, Newark, NJ, USA Kessler Institute for Rehabilitation, West Orange, NJ, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Barrett
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010468:Perceptual Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function / Q000502:physiology*; D013028:Space Perception / Q000502:physiology; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D000071939:Stroke Rehabilitation / Q000379:methods*; D016896:Treatment Outcome
keywords: lesion mapping; motor-intentional; prism adaptation; spatial cognition; spatial neglect; stroke rehabilitation