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

左单侧空间忽视会对日常生活造成许多功能衰弱的影响。然而，没有一种康复技术显示出对症状的持久效果。在改善忽视的试验中，我们利用保留的语言功能的方法是非常独特的。我们已经证明，永恒的语言线索促进忽视患者的表现。因此，我们认为言语功能有可能克服解决视觉空间任务的困难，只要它是自发使用的。本研究旨在发展一种单侧空间忽视的自我诱导言语康复方法。首先，分析了忽视与偏视病感失认的关系，认为忽视的主要问题是对病情的认识。正如我们所假设的那样，结果显示有忽视的偏视患者比没有忽视的偏视患者更容易意识到自己的视野缺陷。其次，探讨了健康老年人的语言功能对视觉空间功能的贡献。正如预期的那样，在一些任务中观察到诸如程序、图形和数字等信息的语言化。然后我们做了一个特殊的任务，本质上是视觉空间的，但如果同时使用语言功能，就会更容易解决。健康对照组在使用语言功能和视觉空间功能时的表现明显优于仅使用视觉空间功能时的表现。最后，将该任务应用于重度、中度和轻度忽视的患者，希望他们能够自发地使用语言功能，体验其优越性。令人惊讶的是，在他们的表现中从未观察到视觉空间和语言功能的结合。即使是非常轻微的忽视患者也不能使用他的语言功能来解决任务，坚持从视觉空间的角度来看它的态度。保留函数的补偿是未来被忽视的问题。少

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