Department of Psychology, University of Milano-Bicocca, Milano, Italy; Milan Centre for Neuroscience, Milano, Italy; Centre for Research in Optics and Optometry, University of Milano-Bicocca (COMIB), Milano, Italy; Institute of Research and Studies in Optics and Optometry, Vinci, Italy.
Rehabilitation Department, A.S.S.T. Valle Olona, Varese, Italy.
Cortex. 2019 Apr;113:298-311. doi: 10.1016/j.cortex.2018.12.021. Epub 2019 Jan 14.
Prism adaptation (PA) has proven to be effective in alleviating many signs of unilateral spatial neglect (USN). Generally, the principal improvement after PA treatment was found to be in the high-level cognitive function. Nevertheless, some evidence has also been found for it in somatosensory function. We have aimed to test the influence of PA on neglect hemianesthesia, a condition in which the high-level neglect-related deficit mimics hemianesthesia. Twenty-one USN patients were enrolled in the study. Each patient performed two sessions of PA, one with neutral glasses and one with prism glasses using a cross-over design. Sensitivity on the upper limb was tested using two methods. The first task was the sensibility subtest which was derived from the standard clinical examination. The second was the perceptual and motor electro-cutaneous threshold on the forearms using an electro-cutaneous stimulator. Four neuropsychological tests were used to diagnose USN and to check improvement: Star cancellation, Line bisection, Sentence reading and the Comb & Razor test. Comparing prism with sham conditions, our results show significant improvements in double extinction and in the electro-cutaneous perceptual threshold only for the contralesional hand. No improvement was found for the ipsilesional hand, for the motor threshold, and for neutral glasses. Significant improvement was found in personal neglect. Replication of the task in a subgroup of patients confirmed the primary results. The improvements in somatosensory perception together with the amelioration of personal neglect suggest that PA also has a specific effect on the neglect hemianesthesia.
棱镜适应（PA）已被证明能有效缓解单侧空间忽略（USN）的许多症状。通常，PA 治疗后的主要改善被发现在高级认知功能上。然而，在躯体感觉功能上也有一些证据。我们旨在测试 PA 对忽视性半侧感觉缺失的影响，这是一种高级忽略相关缺陷模拟半侧感觉缺失的情况。21 名 USN 患者被纳入研究。每位患者进行两次 PA 治疗，一次使用中性眼镜，一次使用棱镜眼镜，采用交叉设计。使用两种方法测试上肢的敏感性。第一项任务是从标准临床检查中得出的感觉敏度测验。第二项是使用皮肤电刺激器在前臂上进行感知和运动性电皮肤阈值测试。使用四项神经心理学测试来诊断 USN 并检查改善情况：星号删除、直线划分、句子阅读和梳子与剃须刀测试。与假棱镜条件相比，我们的结果显示，仅在对侧手上，双消光和电皮肤感知阈值有显著改善。同侧手、运动阈值和中性眼镜均无改善。个人忽视方面有显著改善。在患者的一个亚组中重复该任务证实了主要结果。躯体感觉知觉的改善以及个人忽视的改善表明，PA 对忽视性半侧感觉缺失也有特定的影响。
