Rehabilitation unit, University hospital of Bordeaux, 33076 Bordeaux, France; EA4136, Bordeaux University, 33076 Bordeaux, France; Service de médecine physique et de réadaptation, rehabilitation unit, university hospital of Rennes, 35000 Rennes, France.
Incia, UMR CNRS Bordeaux University, 33000 Bordeaux, France.
Ann Phys Rehabil Med. 2020 Jan;63(1):12-20. doi: 10.1016/j.rehab.2019.03.005. Epub 2019 Apr 19.
Unilateral neglect is common among right-hemispheric stroke individuals and also concerns the auditory modality. Prism adaptation can improve auditory extinction during a dichotic listening task, but its effect during an ecological task has not been studied.
The main objective was to evaluate whether lateralized cueing before and after prism adaptation improved virtual spatial navigation of stroke individuals with visual and auditory unilateral neglect. Secondary objectives were to assess spatial memory and obtain a better understanding of the mechanism of the cueing treatment by using an eye-tracker.
We included 22 stroke individuals with left visual and auditory neglect, 14 individuals without neglect, and 12 healthy controls. After a familiarization task, participants underwent 3 evaluation sessions. Participants were first passively shown a path that they had then to actively reproduce by using a joystick. A path with lateralized beeping sounds indicating direction and a path without any sounds were followed in a randomized order. After prism adaptation, the participants followed a third path with lateralized beeping sounds. The time of navigation and number of trajectory mistakes were recorded. After navigation, spatial memory was assessed. Additionally, an eye-tracker was used during the navigation period.
The navigational performance of participants with neglect was significantly better with than without auditory cues, especially after prism adaptation. With auditory cues, participants without neglect reached the navigational performance of healthy controls. The spatial memory of individuals with neglect was significantly lower with auditory cues. Eye-tracking analyses showed that participants with neglect made more saccades and looked longer at the right-square angles in the absence of auditory cues.
This study demonstrates the positive effect of auditory cues in virtual spatial navigation of individuals with visual and auditory neglect and the potentiation of the help of cues after prism adaptation.
单侧忽略在右脑卒中患者中很常见，也涉及听觉模式。棱镜适应可以改善双听任务中的听觉消失，但在生态任务中其效果尚未研究。
主要目的是评估棱镜适应前后的偏侧提示是否改善了有视觉和听觉单侧忽略的中风患者的虚拟空间导航。次要目的是通过眼动追踪器评估空间记忆，并更好地了解提示治疗的机制。
我们纳入了 22 名有左视觉和听觉忽略的中风患者、14 名无忽略的患者和 12 名健康对照者。在熟悉任务后，参与者进行了 3 次评估。参与者首先被动地观看他们必须主动使用操纵杆重现的路径。以随机顺序跟随有偏侧蜂鸣声指示方向的路径和没有任何声音的路径。在棱镜适应后，参与者跟随第三条有偏侧蜂鸣声的路径。记录导航时间和轨迹错误数。导航后，评估空间记忆。此外，在导航期间使用眼动追踪器。
有忽略的参与者在有听觉提示的情况下，导航表现明显优于无听觉提示的情况下，尤其是在棱镜适应后。有听觉提示时，无忽略的参与者达到了健康对照组的导航表现。忽略的个体的空间记忆在有听觉提示时明显较低。眼动追踪分析表明，在没有听觉提示的情况下，忽略的参与者会进行更多的扫视，并且在右正方形角度停留的时间更长。
这项研究表明，听觉提示在有视觉和听觉忽略的个体的虚拟空间导航中具有积极作用，并且棱镜适应后提示的帮助会增强。
