Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic.
Kessler Foundation, West Orange, NJ, United States of America.
PLoS One. 2021 Jan 22;16(1):e0245425. doi: 10.1371/journal.pone.0245425. eCollection 2021.
Spatial neglect (SN) is a common cognitive disorder after brain injury. Prism adaptation treatment (PAT) is one of the promising interventions for SN albeit inconsistent results from previous studies. We carried out a comparison intervention (PAT vs. Sham) and aimed to evaluate the efficacy of PAT on visuospatial symptoms of SN in an inpatient rehabilitation setting that offered a highly intensive comprehensive brain injury rehabilitation program. A total of 34 patients with moderate-to-severe SN secondary to stroke or traumatic brain injury were randomized to the PAT group and the Sham group (an active control group). Both groups received 10 sessions of treatment, over two weeks, in addition to the rehabilitation therapies provided by their rehabilitation care teams. Outcomes were measured using an ecological instrument (the Catherine Bergego Scale) and paper-and-pencil tests (the Bells Test, the Line Bisection Test and the Scene Copying Test). Patients were assessed at baseline, immediately after treatment, two weeks after treatment, and four weeks after treatment. 23 (67.6%) patients completed treatment and all the assessment sessions and were included in the final analyses using mixed linear modeling. While SN symptoms reduced in both groups, we found no difference between the two groups in the degree of improvement. In addition, the average SN recovery rates were 39.1% and 28.6% in the PAT and Sham groups, respectively, but this discrepancy did not reach statistical significance. Thus, the present study suggests that PAT may contribute little to SN care in the context of a highly intensive inpatient rehabilitation program. Further large-scale investigation is required to uncover the mechanisms underlying PAT and Sham in order to refine the treatment or create new interventions.
空间忽略症（SN）是脑损伤后的一种常见认知障碍。棱镜适应治疗（PAT）是治疗 SN 的一种有前途的干预措施之一，尽管之前的研究结果不一致。我们进行了一项比较干预（PAT 与假对照），旨在评估 PAT 在提供高度强化综合脑损伤康复计划的住院康复环境中对 SN 的视觉空间症状的疗效。共有 34 名因中风或创伤性脑损伤而导致中度至重度 SN 的患者被随机分配到 PAT 组和假对照（主动对照组）组。两组均接受了 10 次治疗，为期两周，除了他们的康复治疗团队提供的康复治疗外。使用生态仪器（Catherine Bergego 量表）和纸笔测试（Bells 测试、线条二分测试和场景复制测试）测量结果。在基线、治疗后立即、治疗后两周和治疗后四周对患者进行评估。23 名（67.6%）患者完成了治疗和所有评估，并用混合线性模型对最终分析进行了包括。虽然两组的 SN 症状均有所减轻，但我们发现两组之间的改善程度没有差异。此外，PAT 组和假对照组的 SN 平均恢复率分别为 39.1%和 28.6%，但这种差异没有达到统计学意义。因此，本研究表明，在高度强化的住院康复计划背景下，PAT 对 SN 护理的贡献可能很小。需要进一步进行大规模研究，以揭示 PAT 和假对照的机制，从而改进治疗或创造新的干预措施。
