Affiliations: Laboratory for Neuropsychology, Department of
Neurology, Ghent University, Belgium | Faculty of Social and Behavioural Sciences, University
of Amsterdam, Amsterdam, the Netherlands | IPM Research & Consultancy, the
Netherlands | Department of Neurology, St.Elisabeth and Tweesteden
Hospital Tilburg, the Netherlands | Department of Neurology, University Medical Center
Utrecht & Experimental Psychology, Helmholtz Institute, Utrecht
University, the Netherlands
Note: [] Corresponding author: Dr. G.M.S. Nys, Laboratory for
Neuropsychology, Ghent University Hospital, De Pintelaan 185 (4K3), B-9000
Ghent, Belgium. Tel.: +32 0 93326563; Fax: +32 0 93324555; E-mail:
[email protected]
Abstract: Purpose: At present, prism adaptation is probably the most promising
rehabilitation procedure for hemi-neglect. However, randomised controlled
trials are lacking and no data are available on the effectiveness of prism
adaptation in the treatment of acute neglect. Methods: We followed
sixteen neglect patients using a randomised controlled design in which six
patients received four-day-in-a-row placebo treatment (CG) and ten patients
received four-day-in-a row experimental treatment with 10° rightward
deviating prisms (EG) during their stay on the stroke unit. We examined whether
patients in the EG improved faster than the CG by administering three neglect
tasks (Schenkenberg Line Bisection, Letter Cancellation, Gainotti Scene
Copying) immediately before and after each treatment. Second, we examined
whether patients in the EG demonstrated a better long-term outcome at one month
post-treatment (Behavioural Inattention Test). Results: Patients in the
EG improved faster on spatial tasks (line bisection, cancellation) than the CG
but not on visuo-construction. Patients in the EG showed no differences with
the CG in neglect outcome at one month post-treatment. Conclusions: Four consecutive prism sessions produced beneficial effects in patients with acute
neglect. However, prism effects were either short-term, or placebo treatment
with repeated pointing and/or repeated neglect testing was more helpful than we
anticipated. Our results emphasize the importance of a placebo condition and a
follow-up in rehabilitation studies.
