Development of a rehabilitation technique for unilateral spatial neglect using spontaneous verbal instruction

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Left unilateral spatial neglect induces many functionally debilitating effects on everyday life. However, there is no rehabilitation technique which shows long-lasting effect on the symptom. Among trials to improve neglect, our approach to utilize preserved verbal function is quite unique. We have demonstrated that eternalverbal cues facilitate the performance of neglect patients. We thus consider that it is possible that verbal function overcomes the difficulty in solving visuo-spatial tasks, if only it is utilized spontaneously. This study aims to develop a rehabilitation technique for unilateral spatial neglect, by way of self-induced verbal instruction.Firstly, relationship between neglect and anosognosia for hemianopia was analyzed, since awareness of the situation was considered to be the main problem of neglect. As we assumed, the results revealed that hemianopic patients with neglect were unaware of their visual field defect significantly more often than those without neglect.S … More econdly, contribution of language function to visuo-spatial function was explored among healthy elderly people. As expected, verbalization of information such as procedure, figure, and number was observed in some tasks. We then made a special task which was visuo-spatial in nature, but could be solved more easily if verbal function was used at the same time. The healthy controls performed significantly better when they used verbal function together with visuo-spatial function than when they only used visuo-spatial function.Lastly, the task was applied to patients with severe, moderate, and mild neglect in the hope that they would spontaneously utilize verbal function, experiencing its superiority. Surprisingly, combination of visuo-spatial and verbal functions was never observed in their performance. Even a patient with very mild neglect could not use his verbal function in solving the task, sticking to the attitude to see it from visuo-spatial point of view. Compensation of preserved function is the future problem of neglect. Less