Affiliations: [a] 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
| [b] Institute of Psychology, University of Wroclaw, Wroclaw, Poland
| [c] Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland
| [d] Vascular Laboratory, Institute of Psychiatry and Neurology, Warsaw, Poland
Correspondence:
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Address for correspondence: Szczepan Iwański, 2nd Department of Neurology, Institute of Psychiatry and Neurology, 9 Sobieskiego Str., 02-957 Warsaw, Poland. Tel.: +0048 22 458 28 70; E-mail: iwanski@ipin.edu.pl.
Abstract: BACKGROUND:Visuospatial neglect (VSN) may be caused by an inter-hemispheric imbalance of neural activity after brain injury. Repetitive transcranial magnetic stimulation (rTMS) allows rebalancing restoration to a certain degree, relieving neglect symptoms. OBJECTIVE:This study investigates the therapeutic effect of 1 Hz rTMS applied over the left angular gyrus combined with visual scanning training in patients with left VSN in the subacute stroke phase. METHODS:Twenty-eight patients with VSN were randomly assigned to either experimental (fifteen sessions of rTMS consisted of 1800 magnetic pulses delivered to the left angular gyrus with a neuronavigation control), or control group (fifteen sessions of sham stimulation), followed by visual scanning training. VSN severity was assessed both before and after treatment with a 3-month follow up employing the Behavioural Inattention Test and functional measures. RESULTS:No statistically significant differences were detected in outcome measures between the rTMS and sham groups after completion of 3-week therapy and at 3-month follow up. The magnitude of stimulation effects was not associated either with lesion volume, its location, or baseline motor threshold. CONCLUSIONS:Our study did not confirm efficacy of 1 Hz rTMS over the angular gyrus as an adjuvant method to visual scanning training in patients with VSN in the subacute stroke.
Keywords: Neglect, cerebrovascular disease/accident and stroke, rehabilitation, transcranial magnetic stimulation, visual scanning training
