Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano Milano, Italy ; Department of Psychology, University of Milano-Bicocca Milano, Italy.
Front Hum Neurosci. 2013 Feb 12;7:29. doi: 10.3389/fnhum.2013.00029. eCollection 2013.
Prism adaptation improves a wide range of manifestations of left spatial neglect in right-brain-damaged patients. The typical paradigm consists in repeated pointing movements to visual targets, while patients wear prism goggles that displace the visual scene rightwards. Recently, we demonstrated the efficacy of a novel adaptation procedure, involving a variety of every-day visuo-motor activities. This "ecological" procedure proved to be as effective as the repetitive pointing adaptation task in ameliorating symptoms of spatial neglect, and was better tolerated by patients. However, the absence of adaptation and aftereffects measures for the ecological treatment did not allow for a full comparison of the two procedures. This is important in the light of recent findings showing that the magnitude of prism-induced aftereffects may predict recovery from spatial neglect. Here, we investigated prism-induced adaptation and aftereffects after ecological and pointing adaptation procedures. Forty-eight neurologically healthy participants (young and aged groups) were exposed to rightward shifting prisms while they performed the ecological or the pointing procedures, in separate days. Before and after prism exposure, participants performed proprioceptive, visual, and visual-proprioceptive tasks to assess prism-induced aftereffects. Participants adapted to the prisms during both procedures. Importantly, the ecological procedure induced greater aftereffects in the proprioceptive task (for both the young and the aged groups) and in the visual-proprioceptive task (young group). A similar trend was found for the visual task in both groups. Finally, participants rated the ecological procedure as more pleasant, less monotonous, and more sustainable than the pointing procedure. These results qualify ecological visuo-motor activities as an effective prism-adaptation procedure, suitable for the rehabilitation of spatial neglect.
棱镜适应改善了右脑损伤患者多种左侧空间忽略的表现。典型的范式包括重复指向视觉目标的动作，同时患者佩戴棱镜眼镜，使视觉场景向右移动。最近，我们证明了一种新的适应程序的有效性，该程序涉及各种日常视动活动。这种“生态”程序在改善空间忽略症状方面与重复指向适应任务同样有效，并且患者更能耐受。然而，由于缺乏对生态治疗的适应和后效测量，因此无法对两种程序进行全面比较。鉴于最近的研究结果表明，棱镜引起的后效的幅度可能预测空间忽略的恢复，这一点很重要。在这里，我们研究了生态和指向适应程序后的棱镜诱导适应和后效。四十八名神经健康的参与者（年轻组和老年组）分别在不同的日子里佩戴向右移动的棱镜，同时进行生态或指向适应程序。在棱镜暴露之前和之后，参与者进行了本体感觉、视觉和视觉本体感觉任务，以评估棱镜引起的后效。参与者在两个程序中都适应了棱镜。重要的是，生态程序在本体感觉任务（年轻组和老年组）和视觉本体感觉任务（年轻组）中引起了更大的后效。在两个组的视觉任务中也发现了类似的趋势。最后，参与者将生态程序评为比指向程序更愉快、不那么单调和更可持续。这些结果将生态视动活动定性为一种有效的棱镜适应程序，适用于空间忽略的康复。
