Neurorehabilitation of Visual Neglect: A Narrative Review of Approaches from A.R. Luria to Modern Clinical Protocols

Various methods of rehabilitation for patients with neglect syndrome have been developed in cognitive neuropsychology. In contrast, this issue has not been a central focus in Luria's neuropsychological rehabilitation.

The aim of this study is to provide a comparative analysis of A.R. Luria's methods for restoring higher mental functions (HMF) and existing approaches within the cognitive paradigm for rehabilitating patients with left-sided spatial neglect. These approaches will be evaluated based on concepts of "bottom-up" and "top-down" attention processes.

The search for studies was conducted in the electronic databases PubMed, Scopus, Web of Science, and eLIBRARY.RU for the period from 1984 to 2024. Sources were included in the review if they contained information on techniques for overcoming left-sided visual neglect and assessing their effectiveness. The review considered publications across all study designs.

Based on an analysis of 56 publications, this study presents the first comparison between modern rehabilitation methods for left-sided neglect and A.R. Luria's methods for restoring HMF. This synthesis has enabled a refinement of the existing taxonomy of methods for restoring HMF, leading to the proposal of a novel methodology, which focuses on "expanding/correcting the capabilities of the leading afferentation of the functional system (directed correction)".

It is evident that the extant methodologies for addressing left-sided visual neglect are deficient in terms of efficacy. The most efficacious methods are those aimed at restructuring the functional system and based on arbitrariness and mediation, which largely correlates with "top-down" attention processes.