Public Release: 

Stroke researchers link frontal lesions with improved spatial neglect after prism therapy

Integrity of medial temporal structures in the frontal lobe may support functional improvement after prism therapy

Kessler Foundation

West Orange, NJ. December 2, 2014. Stroke researchers have found that the presence of frontal lesions predicts better functional improvement in individuals with spatial neglect who received prism adaptation therapy. "Integrity of medial temporal structures may predict better improvement of spatial neglect with prism adaptation treatment" (doi: 10.1007/s11682-012-9200-5) was published in September in the Neuroimaging and Rehabilitation Special Issue of Brain Imaging & Behavior. The authors are Peii Chen, PhD, Priyanka Shah, and A.M. Barrett, MD, of Kessler Foundation, Kelly M. Goedert of Seton Hall University, and Anne L. Foundas of the University of Missouri.

The study was conducted in 21 patients with left-sided spatial neglect, a common complication of right-brain stroke. The participants underwent 2 weeks of prism adaptation treatment, and 4 weeks of followup. Examination of clinical scans showed that 3 participants had frontal lesions; 8 had no frontal lesions. "Functional improvement was seen after treatment," noted Dr. Chen, "but not equally among the patients. Those with lesions of the frontal cortex had much greater improvement than those without these lesions. Further examination using voxel-based lesion-behavior mapping revealed that in this group, the integrity of medial temporal structures had been maintained. Additional research is needed to determine the course of spatial neglect in this subset of patients, and whether they may respond better to prism therapy."

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The study was funded by the National Institutes of Neurological Disorders & Stroke (R01 NS055808, Barrett), the Eunice Kennedy Shriver Institute of Child Health & Development (K24 HD062647, PI, Barrett), and Kessler Foundation.

About Stroke Rehabilitation Research at Kessler Foundation

Research studies span all domains of post-stroke cognitive dysfunction, but emphasize hidden disabilities after stroke, including hidden disabilities of functional vision (spatial bias and spatial neglect). Students, resident physicians, and post-doctoral trainees are mentored in translational neuroscience of rehabilitation. Dr. Barrett and her colleagues work closely with the clinical staff at Kessler Institute for Rehabilitation. Among their collaborative efforts are the founding of the Network for Spatial Neglect and development of the Kessler Foundation Neglect Assessment Process (KF-NAPTM). Stroke Research receives funding from the Department of Education/NIDRR; the National Institutes of Neurological Disorders & Stroke, the National Institutes of Health/NICHD/NCMRR; Kessler Foundation; the Healthcare Foundation of New Jersey; and the Wallerstein Foundation for Geriatric Improvement. Scientists have faculty appointments at Rutgers New Jersey Medical School.

About A.M. Barrett, MD

A.M. Barrett, MD, a cognitive neurologist and clinical researcher, studies brain-behavior relationships from the perspectives of cognitive neurology, cognitive neuroscience, and cognitive neurorehabilitation. Dr. Barrett is an expert in hidden cognitive disabilities after stroke, which contributes to safety problems & rehospitalization, increased caregiver burden, & poor hospital-to-home transition. She is a founder of the Network for Spatial Neglect, which promotes multidisciplinary research for this underdiagnosed hidden disability. Dr. Barrett is also professor of physical medicine & rehabilitation at Rutgers New Jersey Medical School and adjunct professor of neurology at Columbia University School of Medicine. She is a former president of the American Society for Neurorehabilitation.

Dr. Barrett is author of the reference article Spatial Neglect on emedicine.com.

Relevant publications by Stroke Rehabilitation Research:

  • Barrett AM, Muzaffar T. Spatial cognitive rehabilitation and motor recovery after stroke. Curr Opin Neurol 2014;27:653-8. doi: 10.1097/WCO.0000000000000148

  • Barrett AM. Picturing the body in spatial neglect: descending a staircase. Neurology. 2013 Oct 8;81(15):1280-1.

  • Goedert KM, Chen P, Boston RC, Foundas AL, Barrett AM. Presence of motor-intentional aiming deficit predicts functional improvement of spatial neglect with prism adaptation. Neurorehabilitation and Neural Repair epub Dec 27 2013. DOI: 10.1177/1545968313516872

  • Barrett AM, Oh-Park M, Chen P, Ifejika NL. Five new things in neurorehabilitation. Neurology Clinical Practice. Epub Nov 13 2014. doi: 10.1212/01.CPJ.0000437088.98407.fa.

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; Facebook.com.KesslerFoundation; Tweet us @KesslerFdn

Contacts:

Carolann Murphy, 973.324.8382, CMurphy@KesslerFoundation.org

Lauren Scrivo, 973.324.8384, 973.768.6583 - c, LScrivo@KesslerFoundation.org

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