Left-hand somatosensory stimulation combined with visual scanning training in rehabilitation for post-stroke hemineglect: a randomised, double-blind study

Neuropsychol Rehabil. 2009 Jun;19(3):364-82. doi: 10.1080/09602010802268856. Epub 2008 Jul 1.

Abstract

The aim of this randomised, double-blind study was to investigate the therapeutic effectiveness of left-hand electrical stimulation for patients with post-stroke left visuo-spatial neglect. This approach was hypothesised to enhance activation of the right hemisphere attention system and to improve visual exploration of extrapersonal space. Participants (n = 40) in the study were in a relatively early stage of recovery from their first right hemisphere stroke, and were randomly assigned to the experimental (E) or control (C) group. Group E received conventional visual scanning training combined with electrostimulation of the left hand, while Group C received scanning training with sham stimulation. Their visuo-spatial neglect was assessed twice, prior to the rehabilitation programme and on its completion, using cancellation tests and a letter-reading task. The effect of electrostimulation on hemineglect was assessed following a single administration and after a month-long rehabilitation programme. Although the immediate effect of stimulation was poor, after a month-long rehabilitation period we found significantly greater improvement in Group E patients than in Group C patients. Interestingly, the presence of hemisensory loss did not weaken the observed effect. Therefore, we claim that contralesional hand stimulation combined with visual scanning was a more effective treatment for hemineglect rehabilitation than scanning training alone.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Brain Ischemia / complications
  • Brain Ischemia / rehabilitation
  • Electric Stimulation Therapy*
  • Female
  • Functional Laterality
  • Hand
  • Humans
  • Intracranial Hemorrhages / complications
  • Intracranial Hemorrhages / rehabilitation
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Perceptual Disorders / etiology*
  • Perceptual Disorders / rehabilitation*
  • Rehabilitation / methods
  • Space Perception
  • Stroke / complications*
  • Stroke Rehabilitation*
  • Treatment Outcome
  • Visual Perception