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

Simone Hopfner; Dario Cazzoli; René M Müri; Tobias Nef; Urs P Mosimann; Stephan Bohlhalter; Tim Vanbellingen; Thomas Nyffeler

doi:10.1016/j.neuropsychologia.2014.10.018

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

Neuropsychologia. 2015 Jul:74:145-51. doi: 10.1016/j.neuropsychologia.2014.10.018. Epub 2014 Oct 23.

Authors

Simone Hopfner¹, Dario Cazzoli², René M Müri³, Tobias Nef⁴, Urs P Mosimann⁵, Stephan Bohlhalter⁶, Tim Vanbellingen⁶, Thomas Nyffeler⁷

Affiliations

¹ Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Switzerland.
² Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Switzerland; Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland.
³ Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Switzerland; Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Switzerland; Gerontechnology & Rehabilitation Group, University of Bern, Switzerland.
⁴ Gerontechnology & Rehabilitation Group, University of Bern, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland.
⁵ Gerontechnology & Rehabilitation Group, University of Bern, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland; University Hospital of Old Age Psychiatry, University of Bern, Switzerland.
⁶ Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Switzerland; Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland.
⁷ Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital and University of Bern, Switzerland; Gerontechnology & Rehabilitation Group, University of Bern, Switzerland; Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland. Electronic address: thomas.nyffeler@luks.ch.

PMID: 25455568
DOI: 10.1016/j.neuropsychologia.2014.10.018

Abstract

Continuous theta burst stimulation (cTBS) represents a promising approach in the treatment of neglect syndrome. 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.

Keywords: Cancellation task; Continuous theta burst simulation; Pursuit training; Spatial neglect.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Analysis of Variance
Female
Functional Laterality / physiology
Humans
Male
Middle Aged
Perceptual Disorders / etiology
Perceptual Disorders / therapy*
Psychomotor Performance / physiology*
Pursuit, Smooth / physiology*
Stroke / complications
Theta Rhythm*
Transcranial Magnetic Stimulation / methods*