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This article is part of the Research Topic Novel insights in rehabilitation of neglect

Original Research ARTICLE

Front. Hum. Neurosci., 30 July 2013 | http://dx.doi.org/10.3389/fnhum.2013.00373

Combined space and alertness related therapy of visual hemineglect: effect of therapy frequency

Walter Sturm1*, M. Thimm1, F. Binkofski1, H. Horoufchin1, G. R. Fink2,3, J. Küst4, H. Karbe5 and K. Willmes1
  • 1Department of Neurology, Clinical Neuropsychology, Section Neuropsychology, University Hospital RWTH University, Aachen, Germany
  • 2Department of Neurology, University Hospital Cologne, Cologne, Germany
  • 3Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM3), Research Center Jülich, Jülich, Germany
  • 4Schmieder Clinic, Neurological Rehabilitation Centre, Allensbach, Germany
  • 5Neurological Rehabilitation Centre Godeshöhe, Bonn, Germany

The combined efficacy of space- and alertness related training in chronic hemineglect was tested behaviorally and in a longitudinal fMRI study. Earlier results had shown that both space as well as alertness related training as single intervention methods lead to short term improvement which, however, is not stable for longer time periods. The neurobiological data obtained in these studies revealed differential cortical reorganization patterns for the two training approaches thereby leading to the hypothesis that a combination of both trainings might result in stronger and longer lasting effects. The results of our current study, however, – at least at first glance – do not clearly corroborate this hypothesis, because neither alertness training alone nor the combination with OKS on the group level led to significant behavioral improvement, although four of the six patients after alertness and even more after combined training showed a higher percentage of behavioral improvement than during baseline. Despite the lack of clearcut behavioral training induced improvement we found right parietal or fronto-parietal increase of activation in the imaging data immediately after combined training and at follow-up 3 weeks later. The study design had called for splitting up training time between the two training approaches in order to match total training time with our earlier single training studies. The results of our current study are discussed as a possible consequence of reduced training time and intensity of both training measures under the combined training situation.

Keywords: neglect, therapy frequency, therapy duration, alertness, optokinetic stimulation, spatial attention, reorganization

Citation: Sturm W, Thimm M, Binkofski F, Horoufchin H, Fink GR, Küst J, Karbe H and Willmes K (2013) Combined space and alertness related therapy of visual hemineglect: effect of therapy frequency. Front. Hum. Neurosci. 7:373. doi: 10.3389/fnhum.2013.00373

Received: 17 April 2013; Accepted: 27 June 2013;
Published online: 30 July 2013.

Edited by:

Tanja Nijboer, Utrecht University, Netherlands

Reviewed by:

Mario Bonato, Ghent University, Belgium
Igor Christian Schindler, University of Hull, UK

Copyright: © 2013 Sturm, Thimm, Binkofski, Horoufchin, Fink, Küst, Karbe and Willmes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Walter Sturm, Department of Neurology, Clinical Neuropsychology, University Hospital RWTH Aachen University, Pauwelsstraße 30, D-52074 Aachen, Germany e-mail: sturm@neuropsych.rwth-aachen.de