Chapter

Clinical Systems Neuroscience

pp 359-381

Date:

Testing Cognition and Rehabilitation in Unilateral Neglect with Wedge Prism Adaptation: Multiple Interplays Between Sensorimotor Adaptation and Spatial Cognition

  • Yves RossettiAffiliated withCentre de Recherche en Neurosciences de Lyon, ImpAct team, Inserm, CNRS, Université de LyonHospices Civils de Lyon, Service de Médecine Physique et Réadaptation Neurologique, Plate-forme Mouvement et Handicap, Hôpital Henry Gabrielle Email author 
  • , Sophie Jacquin-CourtoisAffiliated withCentre de Recherche en Neurosciences de Lyon, ImpAct team, Inserm, CNRS, Université de LyonHospices Civils de Lyon, Service de Médecine Physique et Réadaptation Neurologique, Plate-forme Mouvement et Handicap, Hôpital Henry Gabrielle
  • , Marco CalabriaAffiliated withCentre de Recherche en Neurosciences de Lyon, ImpAct team, Inserm, CNRS, Université de LyonUniversitat Pompeu Fabra
  • , Carine MichelAffiliated withINSERM U1093 Cognition, Action, et Plasticité Sensorimotrice Université de Bourgogne
  • , Shaun GallagherAffiliated withDepartment of Philosophy, University of Memphis
  • , Jacques HonoréAffiliated withCentre de Recherche en Neurosciences de Lyon, ImpAct team, Inserm, CNRS, Université de Lyon
  • , Jacques LuautéAffiliated withCentre de Recherche en Neurosciences de Lyon, ImpAct team, Inserm, CNRS, Université de LyonHospices Civils de Lyon, Service de Médecine Physique et Réadaptation Neurologique, Plate-forme Mouvement et Handicap, Hôpital Henry Gabrielle
  • , Alessandro FarnéAffiliated withCentre de Recherche en Neurosciences de Lyon, ImpAct team, Inserm, CNRS, Université de Lyon
  • , Laure PisellaAffiliated withCentre de Recherche en Neurosciences de Lyon, ImpAct team, Inserm, CNRS, Université de Lyon
    • , Gilles RodeAffiliated withCentre de Recherche en Neurosciences de Lyon, ImpAct team, Inserm, CNRS, Université de LyonHospices Civils de Lyon, Service de Médecine Physique et Réadaptation Neurologique, Plate-forme Mouvement et Handicap, Hôpital Henry Gabrielle

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Abstract

Spatial neglect is a neurological condition characterised by deficits for perceiving, attending, representing, and/or performing actions within their left-sided space, responsible for numerous debilitating effects in everyday life, for poor functional recovery, and for decreased ability to benefit from treatment. Exposure to a right lateral displacement of the visual field (induced by a simple target-pointing task with base-left wedge prisms) is known to directionally bias visuomotor coordination and can be compensated by both sensorimotor adaptation and cognitive processes. Sensorimotor adaptation gives rise to after-effects whose duration is amplified in neglect patients and has been repeatedly shown to improve most neglect symptoms. Interestingly the effectiveness of PA has also been demonstrated for non-motor and non-visual tasks, such as for somatosensory extinction, for deficits in mental imagery of geographic maps and in number bisection, and even for visuo-constructive disorders, i.e. for unexposed sensory and motor modalities. Visuomotor adaptation appears to interact with higher-order brain functions related to multisensory integration and can have beneficial effects on sensory processing in different modalities as well as cognition. The bottom-up effects of prism adaptation on spatial cognition can also be applied to patients with complex regional pain syndrome who exhibit a spatial cognition bias towards the affected side. Such bottom-up effects exemplify the powerful potential of new approaches to rehabilitation that rely on physiological grounds and bypass intentional control, resulting in reduced attentional cost. We speculate that bottom-up effects may be completed by rounds of reverberation forming a virtuous circle leading to full-blown therapeutic effects.

Keywords

Bottom-up rehabilitation Chronic regional pain syndrome (CRPS) Prism adaptation Spatial cognition Spatial neglect