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Cognitive Rehabilitation Interventions for Neglect and Related Disorders: Moving from Bench to Bedside in Stroke Patients

¹ Kessler Medical Rehabilitation Research and Education Corporation, West Orange, NJ, ² Moss Rehabilitation Research Institute, Philadelphia, PA, ³ University of Pennsylvania School of Medicine, Philadelphia, ⁴ National Institute of Neurological Disorders and Stroke, Bethesda, MD, ⁵ University of Florida School of Medicine, Gainesville, ⁶ Johns Hopkins University School of Medicine, Baltimore, ⁷ Harvard Medical School, Boston, ⁸ Trinity College, Dublin

Reprint requests should be sent to Emmeline Edwards, National Institute of Neurological Disorders and Stroke, 6001 Executive Boulevard, Room 3305, Bethesda, MD 20892-9531, or via e-mail: ee48r{at}nih.gov.

The spatial neglect syndrome, defined by asymmetric attention and action not attributed to primary motor or sensory dysfunction and accompanied by functional disability, is a major cause of post-stroke morbidity. In this review, we consider the challenges and obstacles facing scientific researches wishing to evaluate the mechanisms and effectiveness of rehabilitation interventions. Spatial neglect is a heterogeneous disorder, for which consensus research definitions are not currently available, and it is unclear which of the deficits associated with the syndrome causes subsequent disability. We review current opinion about methods of assessment, suggest a rational approach to selecting therapies which requires further study, and make systems-level and theoretical recommendations for building theory. We lastly review some creative questions for consideration in future research.

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