title: Enhancing treatment effects by combining continuous theta burst stimulation with smooth pursuit training.
abstract: Continuous theta burst stimulation (cTBS) represents a promising approach in the treatment of neglect syndrome. However, it is not known whether cTBS in conjunction with another technique may enhance the therapeutic effects. In the present sham-controlled study, we aimed to combine cTBS with smooth pursuit training (SPT), another method known to effectively improve neglect symptoms, and to evaluate whether this combination would result in a stronger effect than SPT alone. Eighteen patients with left spatial neglect after right-hemispheric stroke were included in the study and performed a cancellation task on a large 54.6″ touchscreen monitor. A sequential application of cTBS and SPT induced a significantly greater improvement of neglect than SPT alone. After the combined application of these two methods, patients detected significantly more targets and their cancellation behaviour presented a significantly greater shift towards the contralesional hemispace. We suggest that a combined, sequential application of cTBS and SPT is a promising new approach to treat neglect.
authors.affiliation: Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Switzerland.
authors.forename: Simone
authors.initials: S
authors.lastname: Hopfner
authors.affiliation: Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Switzerland; Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland.
authors.forename: Dario
authors.initials: D
authors.lastname: Cazzoli
authors.affiliation: Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Switzerland; Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Switzerland; Gerontechnology & Rehabilitation Group, University of Bern, Switzerland.
authors.forename: René M
authors.initials: RM
authors.lastname: Müri
authors.affiliation: Gerontechnology & Rehabilitation Group, University of Bern, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland.
authors.forename: Tobias
authors.initials: T
authors.lastname: Nef
authors.affiliation: Gerontechnology & Rehabilitation Group, University of Bern, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland; University Hospital of Old Age Psychiatry, University of Bern, Switzerland.
authors.forename: Urs P
authors.initials: UP
authors.lastname: Mosimann
authors.affiliation: Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Switzerland; Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Bohlhalter
authors.affiliation: Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Switzerland; Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland.
authors.forename: Tim
authors.initials: T
authors.lastname: Vanbellingen
authors.affiliation: Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Switzerland; Gerontechnology & Rehabilitation Group, University of Bern, Switzerland; Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland. Electronic address: thomas.nyffeler@luks.ch.
authors.forename: Thomas
authors.initials: T
authors.lastname: Nyffeler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010468:Perceptual Disorders / Q000209:etiology / Q000628:therapy*; D011597:Psychomotor Performance / Q000502:physiology*; D011698:Pursuit, Smooth / Q000502:physiology*; D020521:Stroke / Q000150:complications; D013826:Theta Rhythm; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
keywords: Cancellation task; Continuous theta burst simulation; Pursuit training; Spatial neglect