Treatment of hemispatial neglect by means of rTMS--a review

Cazzoli, Dario; Müri, René M; Hess, Christian W; Nyffeler, Thomas (2010). Treatment of hemispatial neglect by means of rTMS--a review. Restorative neurology and neuroscience, 28(4), pp. 499-510. Amsterdam: IOS Press 10.3233/RNN-2010-0560

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Hemispatial neglect - defined as the failure to attend, explore, and act upon the contralesional side of space - is a frequent and disabling neurological syndrome. Interhemispheric rivalry is considered as a major pathophysiological mechanism underlying hemispatial neglect. According to this account, the contralesional, intact hemisphere undergoes a pathological hyperactivity due to a deficient transcallosal inhibition from the damaged hemisphere. This model offers a framework for possible therapeutic interventions with repetitive transcranial magnetic stimulation (rTMS), i.e. a reduction of the pathological hyperactivity with a rTMS protocol that has lasting inhibitory effects. In the present work, we will first review evidence for the interhemispheric rivalry account coming from animals and humans. We will then describe studies showing the possibility to perturb and to restore interhemispheric balance in healthy subjects as a proof of concept for therapeutic rTMS application. Finally, we will consider studies applying rTMS as a therapeutic approach in hemispatial neglect. We conclude that rTMS is a promising approach to reduce the interhemispheric imbalance in neglect patients and to ameliorate symptoms. Newly developed protocols such as Theta Burst Stimulation (TBS) - with short stimulation times and long offline effects - seem to be particularly convenient. However, future studies should assess stimulation effects not only in clinical testing, but also on disability, considering combination with traditional therapies as well.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
UniBE Contributor:	Cazzoli, Dario, Müri, René Martin, Nyffeler, Thomas
ISSN:	0922-6028
Publisher:	IOS Press
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:14
Last Modified:	05 Dec 2022 14:02
Publisher DOI:	10.3233/RNN-2010-0560
PubMed ID:	20714074
Web of Science ID:	000280975000011
URI:	https://boris.unibe.ch/id/eprint/3350 (FactScience: 207010)