Effectiveness of Prism Adaptation in Neglect Rehabilitation A Controlled Trial Study

Background and Purpose-This study was conducted to investigate the effectiveness on neglect recovery of a 2-week treatment based on prism adaptation (PA) in comparison to an analogous visuomotor training performed without prisms, ie, neutral pointing (NP). Methods-Twenty neglect patients were divided into 2 matched groups, one was submitted to PA (PA group) and the other to NP (NP group) for 10 daily sessions over a period of 2 weeks. After the end of NP treatment, the patients in the NP group were also submitted to PA treatment. Neglect was assessed before and after each treatment and I month after the end of the PA treatment. Results-Visuospatial abilities improved after both PA and NP treatment; however, the improvement was significantly higher in the patients in the PA group than in the patients in the NP group. Moreover, when the patients in the NP group were submitted to PA, they further improved up to the level reached by patients in the PA group, ie, to nonpathological scores. Long-lasting beneficial effects of PA were confirmed I month from the end of treatment. Conclusion-The leftward recalibration of sensorimotor reference frames induced by PA is effective to obtain proper neglect recovery, although visuomotor training based on pointing might partially improve neglect symptoms. (Stroke. 2009;40:1392-1398.)