Enhancing treatment effects by combining continuous theta burst stimulation with smooth pursuit training

Hopfner, Simone; Cazzoli, Dario; Müri, René Martin; Nef, Tobias; Mosimann, Urs Peter; Bohlhalter, Stephan; Vanbellingen, Tim; Nyffeler, Thomas (2015). Enhancing treatment effects by combining continuous theta burst stimulation with smooth pursuit training. Neuropsychologia, 74, pp. 145-151. Elsevier 10.1016/j.neuropsychologia.2014.10.018

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Continuous theta burst stimulation (cTBS) represents a promising approach in the treatment of neglect syndrom. However, it is not known whether cTBS in conjunction with another technique may enhance the therapeutic effects. In the present sham-controlled study, we aimed to combine cTBS with smooth pursuit training (SPT), another method known to effectively improve neglect symptoms, and to evaluate whether this combination would result in a stronger effect than SPT alone. Eighteen patients with left spatial neglect after right-hemispheric stroke were included in the study and performed a cancellation task on a large 54.6" touchscreen monitor. A sequential application of cTBS and SPT induced a significantly greater improvement of neglect than SPT alone. After the combined application of these two methods, patients detected significantly more targets and their cancellation behaviour presented a significantly greater shift towards the contralesional hemispace. We suggest that a combined, sequential application of cTBS and SPT is a promising new approach to treat neglect.

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