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Székely O, Ten Brink AF, Mitchell AG, Bultitude JH, McIntosh RD. No short-term treatment effect of prism adaptation for spatial neglect: An inclusive meta-analysis. Neuropsychologia 2023; 189:108566. [PMID: 37149126 DOI: 10.1016/j.neuropsychologia.2023.108566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 03/31/2023] [Accepted: 04/17/2023] [Indexed: 05/08/2023]
Abstract
Despite 25 years of research on the topic, there is still no consensus on whether prism adaptation is an effective therapy for visuospatial neglect. We have addressed this question through a meta-analysis of the most well-controlled studies on the topic. Our main meta-analytic model included studies with a placebo/sham/treatment-as-usual control group from which data from right hemisphere stroke patients and left-sided neglect could be aggregated. The short-term treatment effects on the two commonly used standard tests for neglect, the conventional Behavioural Inattention Test (BIT-C) and cancellation test scores were combined into one random effect model justified by the fact that 89% of the BIT-C score is determined by cancellation tasks. With this approach, we were able to obtain a larger and more homogeneous dataset than previous meta-analyses: sixteen studies including 430 patients. No evidence for beneficial effects of prism adaptation was found. The secondary meta-analysis including data from the Catherine Bergego Scale, a functional measure of activities of daily living, also found no evidence for the therapeutic effects of prism adaptation, although half as many studies were available for this analysis. The results were consistent after the removal of influential outliers, after studies with high risk-of-bias were excluded, and when an alternative measure of effect size was considered. These results do not support the routine use of prism adaptation as a therapy for spatial neglect.
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Affiliation(s)
- Orsolya Székely
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK; Department of Psychology, University of Bath, Claverton Down Road, Bath, Somerset, BA2 7AY, UK.
| | - Antonia F Ten Brink
- Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 8, 3584, CS Utrecht, the Netherlands; Department of Psychology, University of Bath, Claverton Down Road, Bath, Somerset, BA2 7AY, UK; Centre for Pain Research, University of Bath, Claverton Down Road, Bath, Somerset, BA2 7AY, UK
| | - Alexandra G Mitchell
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK; Center of Functionally Integrative Neuroscience, Aarhus University, 1710, Universitetsbyen 3, 8000, Aarhus, Denmark
| | - Janet H Bultitude
- Department of Psychology, University of Bath, Claverton Down Road, Bath, Somerset, BA2 7AY, UK; Centre for Pain Research, University of Bath, Claverton Down Road, Bath, Somerset, BA2 7AY, UK
| | - Robert D McIntosh
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
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