Aparicio-Lopez C, Rodriguez-Rajo P, Sanchez-Carrion R, Ensenat A, Garcia-Molina A
Institut Universitari de Neurorehabilitacio Guttmann-UAB, Badalona, Espana.
Rev Neurol. 2019 Sep 1;69(5):190-198. doi: 10.33588/rn.6905.2019090.
Patients with unilateral visuospatial neglect secondary to a stroke are usually unaware of the fact that their perception and exploration of contralesional space are deficient. This clinical phenomenon, know as anosognosia, directly conditions the rehabilitation process and prolongs its duration to a significant extent, while also making it more difficult for the patient to adhere to it.
To assess the efficacy of a specific rehabilitation programme for the treatment of anosognosia in patients presenting with unilateral visuospatial neglect.
Twelve patients with a stroke in the right hemisphere were divided into two groups. The experimental group received 15 sessions of computerised cognitive therapy along with 15 sessions of specific rehabilitation for anosognosia. The control group underwent 15 sessions of computerised cognitive treatment. All of them were administered, before and after treatment, a battery of tests to evaluate visuospatial attention. The level of functionality was evaluated by means of the Catherine Bergego Scale.
After the intervention, the control group showed statistically significant psychometric differences. The same did not occur with the experimental group. No differences were obtained in the pre- and post-treatment intergroup comparisons, or in the psychometric measures or on the functional scale.
Further research is needed to help us improve the treatment of anosognosia in patients with unilateral visuospatial neglect. Some methodological recommendations emerge from the limitations identified in this study.
中风继发单侧视觉空间忽视的患者通常未意识到他们对患侧空间的感知和探索存在缺陷。这种被称为疾病感缺失的临床现象直接影响康复进程，并在很大程度上延长其持续时间，同时也使患者更难坚持康复治疗。
评估一种针对单侧视觉空间忽视患者疾病感缺失的特定康复方案的疗效。
12例右半球中风患者被分为两组。实验组接受15次计算机化认知治疗以及15次针对疾病感缺失的特定康复治疗。对照组接受15次计算机化认知治疗。所有患者在治疗前后均接受一系列评估视觉空间注意力的测试。通过凯瑟琳·贝热戈量表评估功能水平。
干预后，对照组显示出统计学上显著的心理测量差异。实验组未出现同样情况。治疗前后组间比较、心理测量指标或功能量表方面均未发现差异。
需要进一步研究以帮助我们改善单侧视觉空间忽视患者疾病感缺失的治疗。从本研究中发现的局限性得出了一些方法学建议。
