Searching for methods of rehabilitation in neglect syndrome patients – a review

Unilateral neglect syndrome, a difficulty in reporting, responding, or orienting to novel or meaningful stimuli presented within the contralesional hemispace, is a common consequence of brain injury that cannot be explained by primary sensorimotor defects. It is a heterogeneous cluster of cognitive deficits usually resulting from right hemisphere damage affecting the left part of the body and space. Right hemineglect also occurs, but is much less frequent. Even though about half of patients tend to recover from neglect relatively quickly and spontaneously, chronic forms of the disorder are associated with slowed motor function recovery, poor response to rehabilitation, and difficulties in many everyday activities. This article reviews the theoretical approaches and efficacy of different strategies of neurorehabilitation including such groups of therapeuticmethods as: psychological techniques of compensation (scanning training, lateralized cueing), techniques of sensory modulation (optokinetic stimulation, vestibular stimulation, transcutaneous nerve and muscle stimulation), techniques of sensorimotor plasticity activation (eye patching, adaptation to prism lenses, trunk rotation), and techniques of balancing interhemispheric interactions (limb activation therapy, transcranial magnetic stimulation). Despite years-long clinical observations and numerous experimental studies verifying usefulness of different interventions, it is not clear yet whether one rehabilitation technique is appropriate for all hemineglect patients and diverse manifestations of neglect. Some authors claim that combination of different techniques may produce additive benefits (e.g. linking of specific psychological interventions with sensory manipulation, improving of attention and visuospatial abilities, self-awareness training or pharmacological treatment).