Article

No treatment for auditory neglect and no randomized controlled trial
evaluating smooth pursuit eye movement therapy (SPT) for multimodal neglect are
available. OBJECTIVE: To compare the effects of SPT and visual scanning therapy
(VST) on auditory and visual neglect in chronic stroke patients with neglect.
METHODS: A randomized, prospective trial was conducted. Fifty patients with left
auditory and visual neglect were randomly assigned. Twenty-four patients
completed SPT therapy and 21 patients VST. Five patients (4 VST, 1 SPT) were
lost. Each group received 1-hour sessions of neglect therapy for 5 consecutive
days totaling 5 hours. Outcome measures in visual neglect (digit cancellation,
visuoperceptual- and motor line bisection, paragraph reading) and auditory
neglect (auditory midline) were assessed twice before therapy, thereafter, and at
2-week follow-up. The SPT group practiced smooth pursuit eye movements while
tracking stimuli moving leftward. The VST group systematically scanned the same
but static stimuli. Both groups were divided into subgroups, and effects were
separately investigated for mild and severe neglect.
RESULTS: Both groups did not
differ before therapy in clinical/demographic variables or neglect severity
(auditory/visual). After treatment, the SPT group showed significant and lasting
improvements in all visual measures and normal performance in the auditory
midline. Neither visual nor auditory neglect impairments changed significantly
after VST. Moreover, the treatment effect sizes (Cohen's d) were considerably
higher for visual and auditory neglect after SPT versus VST, both for mild and
severe neglect. CONCLUSIONS: Repetitive contralesional, smooth pursuit training
induces superior, multimodal therapeutic effects in mild and severe neglect.

Langue : ANGLAIS