Auditory spatial cueing reduces neglect after right-hemispheric stroke: A proof of concept study

B C Kaufmann; D Cazzoli; P Bartolomeo; J Frey; T Pflugshaupt; S E J Knobel; T Nef; R M Müri; T Nyffeler

doi:10.1016/j.cortex.2021.12.009

Auditory spatial cueing reduces neglect after right-hemispheric stroke: A proof of concept study

Cortex. 2022 Mar:148:152-167. doi: 10.1016/j.cortex.2021.12.009. Epub 2022 Jan 19.

Authors

B C Kaufmann¹, D Cazzoli², P Bartolomeo³, J Frey⁴, T Pflugshaupt⁴, S E J Knobel⁵, T Nef⁵, R M Müri⁶, T Nyffeler⁷

Affiliations

¹ Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland; Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France; Perception and Eye Movement Laboratory, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
² Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland; Department of Psychology, University of Bern, Bern, Switzerland.
³ Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France.
⁴ Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland.
⁵ ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
⁶ Perception and Eye Movement Laboratory, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
⁷ Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland; Perception and Eye Movement Laboratory, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland. Electronic address: thomas.nyffeler@luks.ch.

PMID: 35176552
DOI: 10.1016/j.cortex.2021.12.009

Abstract

Spatial neglect after right-hemispheric stroke, characterized by the failure to attend or respond to the contralesional space, is a strong negative outcome predictor. Neglect is a supramodal syndrome affecting not only the visual but also the auditory modality. Preliminary studies used this audio-visual cross-modal effect to show short-lasting effects on attention towards the neglected space. The aim of the present study was to introduce a new technique of auditory stimulation combining the unspecific effect of music (i.e., patients choose their preferred music) with the effects of auditory spatial cueing (i.e., the music is presented dynamically as moving from right to left). The effect of this new auditory stimulation technique was investigated in two proof-of-concept experiments using repeated-measures, cross-over designs including 21 patients with visual neglect after a first right-hemispheric stroke. In Experiment I (n = 9), neglect patients showed a significantly larger improvement in Letter Cancellation after listening to preferred music with than without auditory spatial cueing. After granting the feasibility of this new auditory stimulation technique, we investigated the long-term aftereffects in Experiment II (n = 12). Herefore, we used video-oculography during Free Visual Exploration, a sensitive and reliable tool to assess spatial attention over time. Listening to music with auditory spatialcueing - as compared to music without auditory spatialcueing - significantly improved neglect severity in terms of visual exploration behaviour for up to 3h. A voxel-based-lesion-symptom mapping analysis over all patients revealed that the response variability in listening to music with auditory spatial cueing is determined by the integrity of the right inferior parietal lobule, the second branch of the superior longitudinal fascicle, and parieto-parietal callosal fibres. Our study shows that listening to music with auditory spatial cueing significantly reduces neglect severity and has the potential to be used as an add-on in the neurorehabilitation of neglect.

Keywords: Auditory spatial cueing; Cross-modal effect; Free visual exploration; Neglect; Video-oculography.

Publication types

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

MeSH terms

Cues
Functional Laterality / physiology
Humans
Perceptual Disorders* / rehabilitation
Proof of Concept Study
Stroke* / complications