Eye patching in unilateral spatial neglect: Efficacy of two methods

doi:10.1016/S0003-9993(99)90310-6

Archives of Physical Medicine and Rehabilitation

Volume 80, Issue 1, January 1999, Pages 71-76

https://doi.org/10.1016/S0003-9993(99)90310-6 Get rights and content

Abstract

Objectives: To determine whether patches obscuring half the visual field affect eye movement in subjects with unilateral spatial neglect and whether there is consequent improvement in the subject's everyday life, and to interpret the potential changes observed with the aid of a theoretical model.

Design: Prospective and randomized study.

Setting: Rehabilitation medicine department in an urban general hospital.

Patients: Twenty-two subjects with left unilateral neglect.

Intervention: Two eye-patching procedures—right half-field patches (n = 7) and right mononuclar patch (n = 7)—and control group (n = 8).

Main Outcome Measures: Functional tests (FIM) and analytical tests (measurement of right eye movements by photo-oculography) at admission and after 3 months.

Results: Results of the paired comparison tests showed (1) significant differences between the control group and the group with the half-eye patches for total FIM score (p = .01) and the displacements of the right eye in the left field (p = .02), and (2) no significant differences between the control group and the group with the right monocular patch.

Conclusion: Patching the right half-field helped subjects initially regain voluntary control over the deficit. The actual interpretation is based on physiologic and psychophysiologic models.

References (40)

KM Heilman et al.
Hemispace and hemispatial neglect
M Kinsbourne
Mechanisms of unilateral neglect
G Rode et al.
Partial remission of hemiplegia and somatoparaphrenia through vestibular stimulation in a case of unilateral neglect
Cortex
(1992)
T Arai et al.
Hemispatial sunglass: effect of unilateral spatial neglect
Arch Phys Med Rehabil
(1997)
JM Beis et al.
Detection of visual field deficit and visual neglect with computerized light emitting diodes
Arch Phys Med Rehabil
(1994)
JM Beis et al.
Interêt de la photooculographie dans l'evaluation des troubles visuospatiaux en reeducation
Ann Réadapt Med Phys
(1995)
J Hornak
Ocular exploration in the dark by patients with visual neglect
Neuropsychologia
(1992)
MI Posner et al.
How does the parietal lobe direct covert attention?
Neuropsychologia
(1987)
MI Posner et al.
Selective attention and cognitive control
Trends Neurosci
(1987)
E De Renzi
Disorders of space exploration and cognition
(1982)

KM Heilman et al.

Neglect and related disorders

E Bisiach et al.

Unilateral neglect, representational schema and consciousness

Brain

(1979)

MI Posner et al.

Effect of parietal injury on covert orienting of attention

J Neurosci

(1984)

G Denes et al.

Unilateral spatial neglect and recovery from hemiplegia

Brain

(1982)

DB Hier et al.

Recovery of behavioral abnormalities after right hemisphere stroke

Neurology

(1983)

PW Halligan et al.

When is a cue not a cue?

L Diller et al.

Hemi-inattention in rehabilitation: evolution of a rational mediation program

WD Gouvier et al.

Behavioral changes following visual scanning training: observation of five cases

Int J Clin Neuropsychol

(1987)

RC Wagenaar et al.

The transfer of scanning training effects in visual inattention after stroke: five single-case studies

Disabil Rehabil

(1992)

Cited by (107)

The cingulate cortex and spatial neglect
2019, Handbook of Clinical Neurology
Spatial neglect is asymmetric attention, orienting, and action causing functional disability. It is linked to higher-order cortical sensory processing; however, spatial motor “Aiming” processing is critical to fundamental, adaptive environmental movement and daily life function. The cingulate cortex, in particular the anterior cingulate and anterior midcingulate cortex, is strongly linked to spatial Aiming deficits and likely to predict daily life disability in spatial neglect. The authors review the impact and mechanisms of spatial neglect and then describe specific symptoms associated with spatial neglect that are theoretically linked to cingulate cortical functions or associated with lesions extending to cingulate regions in a well-characterized spatial neglect cohort. The treatment implications for a link between cingulate cortex spatial Aiming neglect and therapies that improve spatial action, arousal, and persistence are discussed. Clinicians may want to consider theoretically motivated treatments targeted at specific symptoms as well as use treatments supported for spatial neglect based on unselected and uncharacterized groups.
Rehabilitation of unilateral neglect: Evidence-based medicine
2017, Annals of Physical and Rehabilitation Medicine
Citation Excerpt :
Other authors have attempted to take advantage of the Sprague effect, first described in cats [13], by using a patch on the right eye or the right side of each visual field to stimulate orientation of the eyes towards the left. This procedure simply requires the patient to wear glasses with opaque masks on the right side of the lenses [14]. Prism adaptation has been used for many years to study the plasticity of sensorimotor functions by artificially manipulating the sensorimotor relationships [15].
In the last decades, several rehabilitation methods have been developed to improve spatial neglect. These can be classified according to their theoretical basis: (i) enhance awareness of neglect behaviour through a top-down mechanism; (ii) low-level bottom-up sensory stimulation; (iii) modulation of inhibitory processes; (iv) increase arousal.
The purpose of this study was to provide an overview of the evidence on the effectiveness of rehabilitation procedures for unilateral neglect.
A systematic search was performed to look for all randomised controlled trials aimed at reducing left spatial neglect that included a functional assessment. In addition, recent review papers and meta-analyses were analysed.
Thirty-seven randomized controlled trials were found (12 bottom-up; 12 top-down; 1 interhemispheric competition; 12 combination of approaches) that included 1027 patients with neglect. Although there are some encouraging results, overall, the level of evidence remains low. Poor methodological quality and small sample sizes are major limitations in many published trials.
There is a need for well-conducted, large-scale randomised controlled trials that incorporate blinded assessments, evaluation of the generalization to activities of daily living and long-term follow-up.
Treatment of Cognitive-Perceptual Deficits: A Function-Based Approach. Treatment of Neurobehavioral Impairments (Figure 27-1).
2015, Stroke Rehabilitation: A Function-Based Approach
Treatment of cognitive-perceptual deficits: A function-based approach
2015, Stroke Rehabilitation
Effect of motor tasks with left monocular eyeglasses on visual search and line-bisection performance in people with left unilateral spatial neglect
2022, Neurocase
Non-pharmacological interventions for spatial neglect or inattention following stroke and other non-progressive brain injury
2021, Cochrane Database of Systematic Reviews

View all citing articles on Scopus

^☆: Supported by Laboratoire de Réadaptation ed d'Appareillage, Vandoeuvre les Nancy, and the Centre de Réadaptation pour Grands Handicapés, Lay-Saint-Christophe, France.

^☆☆: No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

View full text

ArticleEye patching in unilateral spatial neglect: Efficacy of two methods☆,☆☆

Abstract

Cortex

Arch Phys Med Rehabil

Arch Phys Med Rehabil

Ann Réadapt Med Phys

Neuropsychologia

Neuropsychologia

Trends Neurosci

Disorders of space exploration and cognition

Neglect and related disorders

Unilateral neglect, representational schema and consciousness

Brain

Effect of parietal injury on covert orienting of attention

J Neurosci

Unilateral spatial neglect and recovery from hemiplegia

Brain

Recovery of behavioral abnormalities after right hemisphere stroke

Neurology

When is a cue not a cue?

Hemi-inattention in rehabilitation: evolution of a rational mediation program

Behavioral changes following visual scanning training: observation of five cases

Int J Clin Neuropsychol

The transfer of scanning training effects in visual inattention after stroke: five single-case studies

Disabil Rehabil

Article
Eye patching in unilateral spatial neglect: Efficacy of two methods☆,☆☆