Brain stimulation procedures for treatment of contralesional spatial neglect

The application of brain stimulation techniques for modulation of cortical excitability changes underlying spatial neglect following right-brain-damage has been the first application of brain stimulation in the rehabilitation setting. Several factors concur in making neglect a prototype of cognitive disorders that can be modulated by brain stimulation: 1) neglect is highly lateralized deficit, 2) neglect is a network disorder in which lesion of a network node impacts affects excitability of intrahemispehric and interhemispheric connections, and 3) lesions of the right hemisphere, the most frequent cause of neglect, are associated with a transcallosally mediated increase of facilitation of the left hemisphere more frequently than are lesions of the left hemisphere associated with right hemisphere facilitation. We review the main applications of TMS for modulation of neglect disorder and we discuss the different potentialities of inhibition of the unaffected and facilitation of the affected hemisphere. Moreover, we suggest potential interactions of TMS with other behavioral techniques in the rehabilitation setting.