Combination of Pursuit Eye Movement Training With Prism Adaptation and Arm Movements in Neglect Therapy: A Pilot Study

Abstract

Objective. The aim of the present study was to determine if a combination of pursuit eye movement training to optokinetic stimulation (OKSP) and prism adaptation leads to greater improvement of neglect symptoms than a single application of OKSP. Additionally, the effect of ipsilesional arm movements during OKSP was tested. Methods. Ten patients with left-sided neglect due to unilateral right-sided vascular brain lesions were studied between 2 and 4.5 months after their stroke. Each patient received 4 different single-session treatments (each lasting 30 minutes): visual scanning treatment (control condition), OKSP, OKSP in conjunction with wearing base-left prisms inducing a shift of the visual field to the right by 10°, and OKSP in conjunction with the right to the left side. Severity of visuospatial neglect was assessed before and directly after each treatment with 4 standard neglect tests. Results. Visual scanning training improved neglect symptoms only slightly. Single OKSP stimulation led to significant improvements in all tests. OKSP in conjunction with prism adaptation was superior to the control condition in the cancellation task. The treatment condition requiring arm movements aggravated neglect symptoms in all tests. A comparison between treatments indicates best improvements may be achieved with OKSP without any additional treatment. Conclusions . The present results give evidence that OKSP significantly reduces symptoms of visuospatial neglect within 1 treatment session. The results suggest that patients should be prevented from performing ipsilesional movements during OKSP.