Kessler Foundation scientists explore evidence for improving outcomes for prism adaptation therapy in stroke survivors

East Hanover, NJ. February 3, 2021. Seeking ways to improve outcomes of stroke rehabilitation, researchers from Kessler Foundation explored available evidence for the neural mechanisms of prism adaptation therapy, an intervention with efficacy for the treatment of spatial neglect. They analyzed published fMRI studies conducted in healthy individuals and stroke survivors with spatial neglect.

Their article, “Neural mechanisms of prism adaptation in healthy adults and individuals with spatial neglect after unilateral stroke” (doi: 10.3390/brainsci11111468) was published open access in Brain Sciences on November 5, 2021. The authors are Olga Boukrina, PhD, and Peii Chen, PhD, of Kessler Foundation. The authors have academic appointments at Rutgers New Jersey Medical School.

Open Access link: https://www.mdpi.com/2076-3425/11/11/1468

Spatial neglect, a neuropsychological syndrome affecting 30 percent of stroke survivors, is characterized by disordered processing of spatial information and diminished control of attention. Prism adaptation treatment using prism goggles has been shown to improve symptoms of spatial neglect, which poses safety risks and hinders progress in rehabilitation. Outcome studies are mixed, however, and the determinants of short- and long-term benefits are unclear.

“Approximately 25 percent of individuals with spatial neglect poststroke fail to benefit from prism adaptation treatment,” said Dr. Boukrina, senior research scientist in the Center for Stroke Rehabilitation Research at Kessler Foundation. “Investigating the neural mechanisms that underly the responses to prism adaptation may provide the direction needed to increase the clinical efficacy of this treatment.”

The team conducted a scoping review and meta-analysis of 15 published papers on prism adaptation and fMRI. “We found that healthy adults and stroke survivors with spatial neglect rely on different neural mechanisms during prism adaptation,” reported Dr. Chen, senior research scientist in the Center for Stroke Rehabilitation Research.

After a single session of prism adaptation, healthy adults increased cerebellar-parietal activation, while individuals with spatial neglect after right brain stroke exhibited activity in different circuits, including a cluster in the intact left hemisphere. “These findings are consistent with a shift in spatial processing to the left hemisphere in spatial neglect caused by right hemisphere stroke,” said Dr. Boukrina. “More research is needed to clarify how lesion location and load on the circuits influence the response to prism adaptation treatment that involves a course of multiple sessions over weeks. Findings will help us identify patients most likely to benefit from prism adaptation treatment and find ways to maximize the benefits for stroke survivors with spatial neglect."     

Funding sources: National Institute on Deafness and Other Communication Disorders (K01DC019178) (OB)

Drs. Boukrina and Chen discuss their research on Steve Adubato’s Lessons in Leadership with Co-host Mary Gamba: https://www.stand-deliver.com/lessons-in-leadership-rodger-derose-peii-peggy-chen-phd-olga-boukrina-phd-warwick-fairfax.html

About Kessler Foundation: Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility, and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit KesslerFoundation.org.

For more information, or to interview an expert, contact Carolann Murphy, 973.324.8382, CMurphy@KesslerFoundation.org.

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