Neurobiomarker for Prism Adaptation Treatment Response

University of Utah

Overview

Preliminary data will be collected about which individuals with spatial neglect from right hemisphere stroke (aiming vs perceptual neglect) improve with Prism Adaptation Training and if there is a particular pattern of damage in the brain that predicts both the type of neglect experienced and whether neglect is improved following Prism Adaptation Training

For preliminary data, twelve individuals with right hemisphere stroke and spatial neglect will participate. After pretesting for type of neglect and its severity, they will have an MRI with Diffusion Tensor Imaging (DTI). Then they will complete 10 sessions of Prism Adaptation Therapy and complete neglect post-testing. Response to Prism Adaptation Therapy will be assessed by comparing neglect scores pre- and post-training. Traditional lesion mapping, structural and functional lesion disconnectivity analyses, and tract-based spatial statistics of DTI measures will be used to examine whether any patterns of damage/dysfunction are related to a diagnosis of aiming neglect and response to Prism Adaptation Therapy.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Conditions

Perceptual Disorders Stroke Biomarker

Interventions

Prism Adaptation TherapyBEHAVIORAL

Participants wear goggles with built-in prisms (a 20-diopter lens) that shift the visual scene to the right. While wearing the googles they reach to and cross out 60 lines/circles, requiring them to learn to reach more leftward than the visual targets appear. Participants can only see the end of their movements.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 1\) within 1 month of right hemisphere stroke 2\) suspected of having unilateral spatial neglect 3\) able to provide consent 4\) likely to remain in rehabilitation for 10-12 days or willing to return to the University to complete 10 sessions of treatment and post-treatment testing 5\) able to have an MRI 6\) will be or has been admitted to the Craig H. Neilson Rehabilitation Hospital for rehabilitation or is able to come to the Craig H. Neilson Rehabilitation Hospital for prism adaptation therapy sessions. 7\) age 18-90 years 8\) able to sit in a wheelchair or other chair for 1 hour 9\) able to point straight ahead and hold a pen with right hand Exclusion Criteria: * 1\) other neurologic, medical that would interfere with ability to complete the testing or training 2\) no uncorrected visual or hearing problems, other than hemianopsia 3\) contraindications to MRI 4\) unable to provide consent due to significant aphasia or cognitive impairment

Locations (1)

University of Utah

Salt Lake City, Utah, United States

Outcomes

Primary Outcomes

Catherine Bergego Scale

asks the impact of neglect behavior on 20 everyday tasks using a 0-3 rating scale. Higher scores = more neglect impact. Total score is sum of item scores

Time frame: baseline before prism adaptation therapy

Catherine Bergego Scale

asks the impact of neglect behavior on 20 everyday tasks using a 0-3 rating scale. Higher scores = more neglect impact. Total score is sum of item scores

Time frame: post-intervention immediately after prism adaptation therapy

Secondary Outcomes

Behavioral Attention Test conventional subtests

traditional neuropsychological subtests (line crossing, letter cancelation, star cancellation, figure and shape copying, line bisection, and representational drawing). Total score is the sum of scores on subtests with highest score being 146. A score of 129 or higher indicates neglect

Time frame: baseline pre-prism adaptation therapy

Behavioral Attention Test conventional subtests

Time frame: post-intervention immediately after prism adaptation therapy

Data from ClinicalTrials.gov

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