Laboratory of Cognitive Neurorehabilitation, Division of Neurorehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Division of Neurorehabilitation, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland.
Neuropsychol Rehabil. 2022 Jul;32(6):1033-1047. doi: 10.1080/09602011.2020.1864412. Epub 2021 Jan 6.
Prismatic adaptation (PA) with wedge prisms is a non-invasive technique used in the rehabilitation of patients suffering from spatial neglect. Unfortunately, as for many behavioural intervention techniques, it is nearly impossible to achieve adequate blinding using wedge prisms, and the potential benefit of PA in the rehabilitation of neglect remains controversial. In order to study an alternative to wedge prism, we examine whether virtual PA at different degrees of deviation may alleviate signs of neglect in a double-blind design. Fifteen neglect patients participated in three adaptation sessions, which differed by the degree of deviation (0°, 15°, or 30°). Performance in line bisection and item cancellation tasks was measured in virtual reality immediately before and after adaptation. Session allocation was concealed from patients and the examiner. Despite the presence of robust, dose-dependent effects of virtual PA on Open-Loop Pointing (OLP), no transfer to line bisection and item cancellation tests were observed. None of the patients were aware of differences between sessions. Virtual PA did not result in visuo-motor transfer effects despite inducing significant adaptation effects in OLP. Together with recent negative findings of randomized-controlled trials, these findings cast doubt on the general efficacy of PA as a rehabilitation method of spatial neglect.
棱晶适应（PA）与楔形棱镜一起被用于治疗空间忽视患者的非侵入性技术。不幸的是，对于许多行为干预技术来说，使用楔形棱镜几乎不可能实现充分的盲法，并且 PA 在忽视康复中的潜在益处仍然存在争议。为了研究楔形棱镜的替代方法，我们在双盲设计中研究了不同偏离程度的虚拟 PA 是否可以减轻忽视的迹象。15 名忽视患者参加了三个适应阶段，其偏离程度不同（0°、15°或 30°）。在适应之前和之后，通过虚拟现实在直线二分和项目取消任务中测量表现。从患者和检查者那里隐藏了会议分配。尽管虚拟 PA 对开环指向（OLP）有明显的、剂量依赖性的影响，但在直线二分和项目取消测试中没有观察到转移。没有患者意识到各阶段之间的差异。虚拟 PA 没有导致视动转移效应，尽管它在 OLP 中引起了明显的适应效应。这些发现与随机对照试验的最近负面结果一起，对 PA 作为空间忽视康复方法的一般疗效产生了怀疑。
