Cognitive rehabilitation for spatial neglect following stroke

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Clinical Psychology

Background:

• Unilateral spatial neglect, a common post-stroke deficit, impairs attention to one side of space.
• Existing rehabilitation strategies lack robust evidence of efficacy.

Purpose of the Study:

• To evaluate the persistent effects of cognitive rehabilitation targeting spatial neglect after stroke.
• Assess outcomes on impairment, disability, and hospital discharge destination.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) focusing on cognitive rehabilitation for spatial neglect.
• Searched multiple databases (MEDLINE, EMBASE, PsycINFO, etc.) and handsearched journals.
• Independent data extraction and quality assessment by two reviewers.

Main Results:

• Included 12 RCTs (306 participants); only four had adequate allocation concealment.
• No statistically significant overall effect on disability; discharge destinations showed mixed results.
• Cognitive rehabilitation improved performance on specific neglect tests (e.g., cancellation errors, line bisection), with effects persisting post-intervention.

Conclusions:

• Insufficient evidence to confirm the effectiveness of neglect-specific interventions for reducing disability or improving independence.
• Interventions can improve performance on standardized neglect tests, warranting further high-quality RCTs.
• Patients with neglect should continue receiving general stroke rehabilitation services.