Treatment of the neglect syndrome in stroke patients using a contingency electrical stimulator

Abstract

Two patients with major infarcts in the right middle cerebral artery territory associated with severe perceptual problems including tactile neglect were treated with a contingency electrical stimulator. This delivered electrical stimuli to the forearm skin on the neglected side whenever the patient moved the contralateral normal arm, with the intention of drawing the patient's attention to the neglected side. The effect of this treatment was assessed in a single case design using the Rivermead Perceptual Assessment Battery. Both patients had a statistically significant improvement in tests of perceptual function during the period of the study. In addition, there was a significant difference between the treatment and the baseline periods: the differences between the slopes of the regression lines fitted to the scores were statistically significant, favouring the treatment periods. This supported the inference that the changes were at least in part due to the treatment rather than merely the natural history of the disease. These results suggest that this approach to treating an otherwise intractable condition should be further investigated.