Significant immediate and limited long-term benefit of prism adaptation on spatial neglect: a systematic review and meta-analysis of RCTs - 23/08/25
, Francois Quesque b , Daisuke Nishida b, c , Sophie Jacquin-Courtois d, e , Jacques Luaute d, e , Eric Chabanat b , Gilles Rode d, e , Yves Rossetti b, d, e, ⁎ Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder
Abstract |
Background |
Although prism adaptation (PA) has been applied in spatial neglect (SN) for 27 years, its efficacy remains controversial and lacks consistency.
Objective |
The first aim was to assess the immediate and long-term effects of prism adaptation (PA) on spatial neglect (SN) via meta-analysis of randomized controlled trials (RCTs). The second aim was to identify potential effect modifiers of PA efficacy.
Methods |
We searched 4 databases up to March 2025 for RCTs comparing PA, or PA+conventional vs. shamPA, or shamPA+conventional, or only conventional in participants with SN, and assessing behavioral or neuropsychological tests (such as Catherine Bergego Scale (CBS) and Behavioral Inattention Test (BIT)). Cochrane risk-of-bias assessment tool and random-effects meta-analysis were used, and effect size was reported as Weighted Mean Difference (WMD) with 95% CI.
Results |
Only 10 RCTs (356 participants) could be included, 8 of them reporting CBS data and 6 for BIT. Immediate PA effects on SN showed a significant improvement for CBS between the PA group (PA/PA+conventional) and control group (shamPA/ shamPA+conventional/only conventional), all studies with prism shift ≥10°, (WMD = -2.13; 95% CI, -3.93 to 0.33; P = 0.020), but non-significance for conventional BIT (BIT-C). Long-term benefit was not significant for CBS, while it was significant for BIT-C when the prism shift was ≥10° (n = 2; WMD = 12.37; 95% CI, 0.53-24.21, P = 0.041). Linear regressions showed non-significant effect modifiers among the participant characteristics or PA intervention parameters. Subgroup analyses for CBS showed a significant immediate improvement in the larger total quantity of prism exposure (number of total trials × prism shift) subgroup (WMD = -2.73; 95% CI, -5.01 to -0.44; P = 0.019), whereas the subgroup with smaller total exposure showed no significant difference.
Conclusion |
Even with stringent inclusion criteria, significant effects of PA on SN were observed in the short-term CBS (all studies with prism shift ≥10°), mainly derived from studies with total exposure ≥11250°·trials. The total quantity of prism exposure (°·trials) may be an applicable effect modifier of PA efficacy.
Trial Registration |
PROSPERO database (registration number: CRD420250650402
Le texte complet de cet article est disponible en PDF.Keywords : Prism adaptation, spatial neglect, Catherine Bergego Scale, Behavioral Inattention Test, meta-analysis
Abbreviations : ADL, BIT, BIT-B, BIT-C, CBS, CI, FIM, FES, M1, MBI, NV, PA, RCT, SN, VR, WMD
Plan
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