Successful return to professional work after neglect, extinction, and spatial misperception - Three long-term case...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Neuropsychology

Background:

• Spatial neglect is a common and disabling stroke-related condition.
• It significantly impairs rehabilitation outcomes and vocational prospects.
• Return to work after severe neglect has not been previously reported.

Purpose of the Study:

• To investigate the possibility of vocational re-integration for stroke survivors with severe spatial neglect.
• To evaluate the effectiveness of specific neuropsychological therapies in addressing neglect and related deficits.
• To document return to work outcomes in patients with extensive right-hemisphere lesions.

Main Methods:

• Case series of three patients with severe left visuospatial neglect and spatial-perceptual deficits post-stroke.
• Inpatient rehabilitation followed by outpatient neuropsychological therapy in four domains: optokinetic stimulation, anti-extinction training, spatial-perceptual feedback, and job-related training.
• Sequential single-subject baseline designs were employed.

Main Results:

• Significant improvements were observed in all treated domains during therapy.
• These improvements were sustained at follow-up.
• All three patients successfully returned to their previous jobs, with two working part-time and one full-time.

Conclusions:

• Return to professional work is achievable for stroke survivors with initially severe neglect and associated visual-perceptual deficits.
• Early and specific neuropsychological rehabilitation can lead to significant functional recovery and vocational re-integration.
• This study demonstrates a potential pathway for improving long-term outcomes in patients with spatial neglect.