Rehabilitation of very severe unilateral neglect by visuo-spatio-motor cueing: Two single case studies

• Published in: Neuropsychological rehabilitation 2000-08, Vol.10 (4), p.385-399
• Main Authors: Samuel, C., Louis-Dreyfus, A., Kaschel, R., Makiela, E., Troubat, M., Anselmi, N., Cannizzo, V., Azouvi, P.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Medical sciences; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reeducation. Readaptation. Sociotherapy; Rehabilitation; Severe; Single case studies; Treatments; Unilateral neglect; Visual-Spatial-Motor cueing
• ISSN: 0960-2011; 1464-0694
• DOI: 10.1080/096020100411970

Robertson, North, and Geggie (1992) have suggested that the voluntary activation of the left upper limb in the left hemispace (spatio-motor cueing) could reduce unilateral neglect. This study assesses the efficacy of visuo-spatio-motor cueing, and particularly the generalisation to daily-life activities, in two patients with very severe neglect who had failed to improve with scanning training. The patients were included in the trial 4 and 7 months after a severe unilateral right hemispheric stroke. They both suffered from disabling unilateral neglect despite intensive conventional therapy. A single-case experimental ABAB design was used (A = baseline with conventional treatment; B = visuo-spatio-motor cueing; each period = 2 weeks). A randomisation test was used to assess the presence of a specific therapeutic effect. In both cases, there was a statistically significant treatment-related improvement on a line bisection test. A parallel improvement was found on neglect behaviourin daily life, as assessed by the Catherine Bergego Scale (Azouvi et al., 1996). The therapeutic effect was maintained at 1-month follow up. These results suggest that visuo-spatio-motor cueing may be efficient in very severe neglect and may help in obtaining generalisation to daily-life activities.