Cognitive rehabilitation for unilateral neglect: Review

Unilateral spatial neglect, a striking difficulty in paying attention to one side of space, is a common consequence of cerebro-vascular disease. Although most patients appear to recover from this deficit relatively quickly, chronic forms of the disorder-usually resulting from right hemisphere damage and affecting left space-are associated with slowed motor recovery, poor response to rehabilitation, and difficulties in many everyday activities. This article reviews the theoretical underpinnings and efficacy of rehabilitation techniques including; behavioural training in leftward visual scanning, eye-patching, encouraging movement of the left limbs, and interventions designed to increase general alertness. Recent highly positive results from brief adaptation training with prism lenses are discussed. "Neglect" is a heterogeneous cluster of deficits that can arise following damage to a variety of brain structures. It is not yet clear whether one rehabilitation technique will be appropriate for all patients/manifestations of the disorder, or whether combining different interventions may produce additive benefits. There is growing evidence that chronic neglect is associated with-indeed possibly fostered by-limitations in a number of non-spatial attentional capacities. Whether reduction of the spatial bias is sufficient, in itself, to improve overall outcome for patients remains an open question.