Behavioural and functional changes in neglect after multisensory stimulation

ABSTRACT

The present cohort study investigated whether systematic multisensory audio-visual stimulation might improve clinical signs of neglect. To this aim, patients with neglect (n = 7) and patients with neglect associated with hemianopia (n = 12) were exposed to a course of audio-visual stimulation with spatially and temporally coincident audio-visual pairs of stimuli for 10 daily training sessions (4 h of training per day), over two weeks. Performance on neuropsychological tests assessing neglect was measured before training, immediately after the training and months after the training at a follow-up session. The results showed significant post-training improvements in clinical signs of neglect, which were stable at the follow-up. These findings suggest that intensive and prolonged multisensory audio-visual stimulation affects orientation towards the neglected hemifield, therefore inducing long-term improvements in visual exploration and neglect symptoms in both patients with neglect and patients with neglect associated with hemianopia. Previous evidence from hemianopic patients suggests that these post-training effects might be mediated by activity in spared subcortical structures, such as the superior colliculus, which are relevant to multisensory integrative processing and spatial orientation.

KEYWORDS:

• Neglect
• hemianopia
• audio-visual stimulation
• rehabilitation
• superior colliculus

Acknowledgements

We are grateful to Silvia Gambino and Perla Da Prà for their help in lesion reconstruction and Brianna Beck for editing the manuscript. The authors declare no potential conflicts of interest.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by grants from the Ministero Istruzione Università e Ricerca to Elisabetta Làdavas [PRIN. Protocol: PRIN2015 NA455] and Caterina Bertini [PRIN2017. Protocol: 2017TBA4KS_003].