Abstract
This study aimed to investigate changes in attention processing after low-frequency repetitive transcranial magnetic stimulation (rTMS) over the left posterior parietal cortex to better understand its role in visuospatial neglect (VSN) rehabilitation. The current study included 10 subacute stroke patients with VSN consecutively recruited from the inpatient stroke rehabilitation center at Xuanwu Hospital (the teaching hospital affiliated with Capital Medical University) between March and November 2019. All patients performed a battery of tasks (including line bisection, line cancellation, and star cancellation tests) two weeks before treatment and at the beginning and end of treatment; the attentive components of the test results were analyzed. In addition, low-frequency rTMS was used to stimulate the left posterior parietal cortex for 14 days and event-related potential data were collected before and after the stimulation. Participants were evaluated using a target-cue paradigm and pencil-paper tests. No significant differences were detected on the battery of tasks before rTMS. However, we found that rTMS treatment significantly improved the response times and accuracy rates of patients with VSN. After rTMS, the treatment side (left) amplitude of P300 following an event-related potential was higher than that before treatment (left target, p = 0.002; right target, p = 0.047). Thus, our findings suggest that rTMS may be an effective treatment for VSN. The observed increase in event-related potential amplitude supports the hypothesized compensational role of the contralesional hemisphere in terms of residual performance. Our results provide electrophysiological evidence that may help determine the mechanisms mediating the therapeutic effects of rTMS.
Highlights
Visuospatial neglect (VSN) is a neuropsychological disorder that impairs higher-level cognition, spatial attention (SA)
The results of the current study showed that interference with repetitive transcranial magnetic stimulation (rTMS) over the unaffected hemisphere can induce an improvement in visuospatial neglect (VSN) accompanied by a higher visual P300 amplitude
We found that the performance of VSN patients taking the paperpencil test was significantly improved after rTMS as compared with spontaneous recovery
Summary
Visuospatial neglect (VSN) is a neuropsychological disorder that impairs higher-level cognition, spatial attention (SA). Deficits in SA impact the processing of sensory events and affect global processing [1]. Negative impacts on SA often occur after a stroke in the right hemisphere and manifest as a failure to respond to stimuli in the contralateral visual field [2]. While spontaneous recovery from VSN can occur, nearly 40% of patients continue to have symptoms [3]. Considering that VSN is a highly debilitating condition that seriously affects the patient recovery and quality of life [4], the development of novel therapeutic methods is needed.
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