Rehabilitation of Unilateral Spatial Neglect: New Insights From Magnetic Resonance Perfusion Imaging
Abstract
Hillis AE. Rehabilitation of unilateral spatial neglect: new insights from magnetic resonance perfusion imaging.
Objective
To illustrate how magnetic resonance perfusion imaging has provided insights regarding rehabilitation of different forms of hemispatial neglect.
Data Sources
Recent studies of different types of neglect and their neural substrates and of rehabilitation strategies that might be differentially effective for different types of neglect.
Study Selection
Author selected all articles on PubMed that were identified with the key words reference frame or perfusion-weighted imaging plus neglect plus rehabilitation and other relevant articles that were cited therein.
Data Extraction
An independent reviewer determined if the data presented provided evidence relevant to planning or developing rehabilitation for stroke patients with distinct forms of neglect.
Data Synthesis
Results from a number of studies converge on the hypothesis that hypoperfusion and/or infarct of right angular gyrus and intraparietal sulcus can cause viewer-centered neglect, whereas hypoperfusion and/or infarct of right superior temporal gyrus can lead to left stimulus-centered neglect. Distinct forms of rehabilitation might be differentially useful for distinct types of spatial neglect, even though an individual patient may have 2 or more types of neglect. Magnetic resonance perfusion imaging has also shown that fluctuations in neglect in the acute-subacute period after stroke are often due to changes in blood flow caused by changes in blood pressure.
Conclusions
Consideration of neglect type and status of cerebral blood flow can be useful in planning strategies to ameliorate each individual’s deficits.
Departments of Neurology and Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine and Department of Cognitive Science, Johns Hopkins University, Baltimore, MD
Reprint requests to Argye E. Hillis, MD, MA, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Phipps 126, 600 N Wolfe St, Baltimore, MD 21287
Supported by the National Institutes of Health (grant no. R01 NS047691).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT