Abstract
Unilateral visuo-spatial neglect is a neuropsychological syndrome commonly resulting from right hemisphere stroke at the temporo-parietal junction of the infero-posterior parietal cortex. Neglect is characterized by reduced awareness of stimuli presented on patients’ contralesional side of space. Inspired by evidence of increased spatial exploration of patients’ left side achieved during keyboard scale-playing, the current study employed a music intervention that involved making sequential goal-directed actions in the neglected part of space, in order to determine whether this would bring about clinically significant improvement in chronic neglect. Two left neglect patients completed an intervention comprising four weekly 30-min music intervention sessions involving playing scales and familiar melodies on chime bars from right to left. Two cancellation tests [Mesulam shape, Behavioral Inattention Test (BIT) star], the neglect subtest from the computerized TAP (Test of Attentional Performance) battery, and the line bisection test were administered three times during a preliminary baseline phase, before and after the four intervention sessions during the intervention phase to investigate short-term effects, and 1 week after the last intervention session to investigate whether any changes in performance would persist. Both patients demonstrated significant short-term and longer-lasting improvements on the Mesulam shape cancellation test. One patient also showed longer-lasting effects on the BIT star cancellation test and scored in the normal range 1 week after the intervention. These findings provide preliminary evidence that active music-making with a horizontally aligned instrument may help neglect patients attend more to their affected side.
Highlights
Spatial neglect is a frequent consequence of right hemispheric stroke, ranging from 13 to 82%, with a number of studies suggesting that approximately half of these individuals manifest some degree of neglect (Stone et al, 1993; Bowen et al, 1999; Buxbaum et al, 2004; Ringman et al, 2004)
One patient showed longer-lasting effects on the Behavioral Inattention Test (BIT) star cancellation test and scored in the normal range 1 week after the intervention. These findings provide preliminary evidence that active music-making with a horizontally aligned instrument may help neglect patients attend more to their affected side
Operating within the broad framework of neurologic music therapy (NMT) (Thaut, 2008), the aim of the present study was to explore whether musical training on a horizontally aligned instrument would increase www.frontiersin.org spatial awareness in patients with chronic unilateral neglect
Summary
Spatial neglect is a frequent consequence of right hemispheric stroke, ranging from 13 to 82%, with a number of studies suggesting that approximately half of these individuals manifest some degree of neglect (Stone et al, 1993; Bowen et al, 1999; Buxbaum et al, 2004; Ringman et al, 2004). Demonstrated through a bias toward ipsilesional space, neglect patients present with impaired attention to stimuli located on the contralesional (usually the left) side of the patient’s body and environment. This leads to difficulties engaging in everyday tasks (Luauté et al, 2006; Bowen and Lincoln, 2008), which in turn reduces functional independence. Despite the large body of research investigating treatment techniques for neglect, recent systematic reviews demonstrate a lack of efficacy of existing rehabilitation approaches, with no consensus regarding which technique is most effective (Luauté et al, 2006; Bowen and Lincoln, 2008) and no strong evidence that these approaches lead to improvements in activities of daily living (see for example, review by Barrett et al, 2012)
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