Adding methylphenidate to prism-adaptation improves outcome in neglect patients. A randomized clinical trial

Area of Science:

• Neurorehabilitation
• Stroke Recovery
• Cognitive Rehabilitation

Background:

• Spatial neglect is a common stroke-related deficit impacting functional recovery.
• Existing therapies for spatial neglect have shown limited effectiveness.
• Evidence for enhancing functional recovery in neglect patients is scarce.

Purpose of the Study:

• To evaluate the efficacy of combining prism adaptation (PA) with methylphenidate (MP) for functional recovery in patients with spatial neglect.
• To assess the impact of this combined therapy on activities of daily living.

Main Methods:

• A multicentre, randomized, double-blind, placebo-controlled trial (RITAPRISM).
• Comparison of PA plus placebo versus PA plus methylphenidate (MP).
• 24 patients with spatial neglect were enrolled and randomized.

Main Results:

• The combination of MP and PA led to significant long-term functional improvement.
• Improvements were observed on the Functional Independence Measure (FIM) and Bergego's scale.
• No serious adverse events were reported during the trial.

Conclusions:

• Adding methylphenidate to prism adaptation provides Class I evidence for improved functional outcomes in neglect patients.
• This combined therapy enhances autonomy in activities of daily living.
• Further research is needed to elucidate the underlying mechanisms of this therapeutic benefit.