Neglect after a stroke is not uncommon. Following a stroke, and especially a right hemispheric one, some patients experience a lack of awareness of one side of their body. While some cases recover spontaneously early on, more persistent unilateral neglect can continue to affect day-to-day living and delay recovery. Notoriously difficult to treat, some experimental therapeutic options are available to aid in recovery. However, the question remains: which of these options is of most clinical value?
Thanks to a group of researchers in Belgium, we might be one step closer to answering that question. Their research collated information from 15 studies in a bid to determine which experimental treatment approach offers the highest likelihood of benefit in unilateral neglect. Of the 15 approaches studied, seven resulted in significant improvement when compared with more conventional methods. Of these, four therapies were found to offer the greatest benefit overall. After reviewing all of the approaches, researchers identified the top 5 treatments.
The ‘Top 5’ therapies for neglect
- TENS: electrical stimulation of neck muscles
Originally developed to treat pain; can also be effective in improving neglect.
- Optokinetic stimulation
A technique where patients look at a PC screen and follow objects (dots) with their eyes.
- Somatosensory electrostimulation
Stimulation of brain areas responsible for movements (one well-known example is transcranial magnetic stimulation, TMS).
- Mirror therapy
A therapy during which the patient sees his healthy side in a mirror, and tries to trick the brain into believing it is his affected side.
- Virtual reality training
Therapy aided by computer technology, for example reaching your arm towards objects visible on a PC screen.
While there is room for further studies to determine which approach is most beneficial in unilateral neglect, this review of contemporary evidence demonstrates that not all treatments are equal.
Talk to your therapist and see if any of the above therapies are available and useful for you.
The lead author of this publication is Dr. Lisa of the Department of Neurological Rehabilitation, Vrije Universiteit Brussel, Jette, Belgium.