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research article

Real-time fMRI and EEG neurofeedback: A perspective on applications for the rehabilitation of spatial neglect

Saj, Arnaud
•
Pierce, Jordan E.
•
Ronchi, Roberta
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September 1, 2021
Annals Of Physical And Rehabilitation Medicine

Spatial neglect is a neuropsychological syndrome characterized by a failure to orient, perceive, and act toward the contralesional side of the space after brain injury. Neglect is one of the most frequent and disabling neuropsychological syndromes following right-hemisphere damage, often persisting in the chronic phase and responsible for a poor functional outcome at hospital discharge. Different rehabilitation approaches have been proposed over the past 60 years, with a variable degree of effectiveness. In this point-of-view article, we describe a new rehabilitation technique for spatial neglect that directly targets brain activity and pathological physiological processes: namely, neurofeedback (NFB) with real-time brain imaging methodologies. In recent proof-of-principle studies, we have demonstrated the potential of this rehabilitation technique. Using real-time functional MRI (rt-fMRI) NFB in chronic neglect, we demonstrated that patients are able to upregulate their right visual cortex activity, a response that is otherwise reduced due to losses in top-down attentional signals. Using real-time electroencephalography NFB in patients with acute or chronic condition, we showed successful regulation with partial restoration of brain rhythm dynamics over the damaged hemisphere. Both approaches were followed by mild, but encouraging, improvement in neglect symptoms. NFB techniques, by training endogenous top-down modulation of attentional control on sensory processing, might induce sustained changes at both the neural and behavioral levels, while being non-invasive and safe. However, more properly powered clinical studies with control groups and longer follow-up are needed to fully establish the effectiveness of the techniques, identify the most suitable candidates, and determine how the techniques can be optimized or combined in the context of rehabilitation. (C) 2021 Elsevier Masson SAS. All rights reserved.

  • Details
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Type
research article
DOI
10.1016/j.rehab.2021.101561
Web of Science ID

WOS:000707327800002

Author(s)
Saj, Arnaud
Pierce, Jordan E.
Ronchi, Roberta
Ros, Tomas
Thomasson, Marine
Bernati, Therese
van de Ville, Dimitri  
Serino, Andrea  
Vuilleumier, Patrik
Date Issued

2021-09-01

Publisher

ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER

Published in
Annals Of Physical And Rehabilitation Medicine
Volume

64

Issue

5

Article Number

101561

Subjects

Rehabilitation

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spatial neglect

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rehabilitation

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neurofeedback

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fmri

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eeg

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prism adaptation

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unilateral neglect

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stimulation

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attention

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cortex

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neuroanatomy

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hemineglect

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modulation

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mechanisms

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components

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
MIPLAB  
LNCO  
Available on Infoscience
November 6, 2021
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/182868
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