title: Randomized controlled trial on hemifield eye patching and optokinetic stimulation in acute spatial neglect.
abstract: OBJECTIVE
  Right hemisphere stroke patients frequently experience spatial neglect, a severe lack of awareness for contralesional hemispace. Although neglect counts among the strongest predictors for poor functional outcome after stroke, there is no established therapy, particularly not for the acute stage.
  
  
  METHODS
  In a randomized controlled trial, we compared the combined treatment of hemifield eye patching and repetitive optokinetic stimulation in acute stroke patients with neglect to the spontaneous course. Outcome measures were a neuropsychological test battery for neglect as well as scales of functional independence and clinical impairment. Outcomes were assessed at baseline (day 1), post treatment (day 8), and at 1-month follow-up (day 30).
  
  
  RESULTS
  Final analysis included 21 acute right hemisphere stroke patients with neglect (23 enrolled, 2 lost to follow-up) allocated either to the treatment (1 week hemifield eye patching and daily sessions of optokinetic stimulation, n=11) or the control group (no neglect-specific treatment, n=10). At baseline, both groups did not differ in neuropsychological test performance, clinical impairment, or functional disability. At the post treatment session, both groups had improved in all these measures, and results were stable or further improved at follow-up. However, there was no significant difference in this change between the treatment and the control group.
  
  
  CONCLUSIONS
  An early intervention of combined hemifield eye patching and optokinetic stimulation in acute stroke patients with spatial neglect has no additive effect to the spontaneous remitting course of the disorder.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov. Unique identifier: NCT01617343.
authors.affiliation: From the Department of Neurology, University Hospital Schleswig-Holstein, Lübeck, Germany. bjoern.machner@neuro.uni-luebeck.de.
authors.forename: Björn
authors.initials: B
authors.lastname: Machner
authors.affiliation: From the Department of Neurology, University Hospital Schleswig-Holstein, Lübeck, Germany.
authors.forename: Inga
authors.initials: I
authors.lastname: Könemund
authors.affiliation: From the Department of Neurology, University Hospital Schleswig-Holstein, Lübeck, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Sprenger
authors.affiliation: From the Department of Neurology, University Hospital Schleswig-Holstein, Lübeck, Germany.
authors.forename: Janina
authors.initials: J
authors.lastname: von der Gablentz
authors.affiliation: From the Department of Neurology, University Hospital Schleswig-Holstein, Lübeck, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Helmchen
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010468:Perceptual Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D012683:Sensory Deprivation; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014796:Visual Perception / Q000502:physiology*
keywords: hemispatial neglect; rehabilitation; stroke