Researchers from the Kessler Foundation Research Center’s Stroke Rehabilitation Research Laboratory, West Orange, NJ, recently presented two studies that may aid in identifying the best candidates for a novel treatment for “spatial neglect,” a hidden, but disabling condition that can complicate recovery from even a mild stroke.
The research studies are titled Effect of Prism Adaptation on “Aiming” Spatial Bias and Functional Abilities, and Prism Adaptation and Learning Curves in Spatial Neglect.
The person with spatial neglect has difficulty recognizing and reacting appropriately to events in a 3-D space on the side opposite the brain injury. Objects may be ignored, or may appear displaced to the right or left. Caregivers may assume the person is not motivated or is intellectually impaired. Untreated, spatial neglect can be the cause of auto accidents, falls, cooking-related injuries, and inadequate personal hygiene. Hidden disabilities like spatial neglect are common after stroke and relatively easy to detect, but are often overlooked.
To detect spatial neglect, clinicians evaluate a person’s ability to perform visual-motor tasks such as bisecting a line, copying simple drawings, and identifying letters in an array. Because perception of their environment, and the ability to move within their environment, is impaired, individuals with spatial neglect make one-sided errors. Prism adaptation, a leading treatment in the field, uses optical lenses to help correct the errors caused by spatial neglect. Investigators at the Stroke Research Laboratory are studying which patients with spatial neglect may be most likely to benefit from prism adaptation.
“We are learning more every day about how to identify and work with hidden disorders of mental function after brain injury,” says Anna M. Barrett, MD, the lab’s director and co-author of both studies. “These studies are a breakthrough in uncovering why prism adaptation treatment may work well for some patients, and some symptoms, and not as well on others.” Targeting patients likely to respond may accelerate their recovery, minimize disability, and lessen the duration and cost of stroke rehabilitation.
Prism Adaptation and Learning Curves in Spatial Neglect, by Jeffrey Kornitzer and colleagues, shows that after prism adaptation, some patients with spatial neglect did not exhibit a classic learning curve. Instead of the typical slow decline in error rates, some participants experienced widely fluctuating error rates. Screening patients for fluctuating errors might help identify candidates for this treatment.
Effect of Prism Adaptation on “Aiming” Spatial Bias and Functional Abilities, by Paola Fortis and colleagues, examines the effects of prism adaptation on two aspects of spatial neglect: ‘aiming’ bias (the ability to act in the environment) and ‘where’ bias (seeing or knowing where). Aiming bias improved with treatment; however, “where” bias, was negatively affected by the treatment. This finding may also aid in identifying which candidates, and which symptoms, will respond to prism adaptation.
Kessler Foundation is among the largest public charities supporting people with physical disabilities. Kessler Foundation Research Center conducts a range of research programs designed to improve function and quality of life for people with physical disabilities due to spinal cord and traumatic brain injury, stroke, multiple sclerosis, and other neurological and orthopedic conditions.
[Source: Kessler Foundation]
