Neglect and Visuospatial Disorders

This review examines rehabilitation interventions for unilateral spatial neglect following stroke. Unilateral spatial neglect occurs in approximately 25% to 30% of stroke survivors and is more commonly associated with right hemisphere lesions involving frontoparietal attention networks. The presence of neglect has been associated with poorer functional recovery, longer rehabilitation stays, reduced independence, and increased need for assistance following discharge. In general, rehabilitation interventions for unilateral spatial neglect may be broadly classified into either compensatory approaches that aim to increase awareness of and attention toward neglected space, or restorative approaches that target impairments in spatial representation, sensory integration, or body orientation. Examples of compensatory interventions include visual scanning retraining, arousal and activation strategies, cueing, and feedback to increase awareness of neglect-related behaviours. Restorative approaches include prism adaptation, eye patching, optokinetic stimulation, neck vibration, caloric stimulation, transcutaneous electrical nerve stimulation, and sensory stimulation techniques. More recently, neuromodulation approaches such as repetitive transcranial magnetic stimulation, theta burst stimulation, and transcranial direct current stimulation have also been explored.