Cognitive Rehabilitation for Unilateral Spatial Neglect
Summary
Unilateral spatial neglect is a disabling disorder of spatial awareness that most commonly arises following stroke to the right cerebral hemisphere. Affected individuals fail to attend, perceive or respond to stimuli presented on the side opposite to their lesion, impairing everyday activities such as dressing, eating and navigation. Cognitive rehabilitation for this syndrome aims to restore spatial attention or to promote compensatory strategies that reduce functional impairment. Interventions span sensory stimulation techniques (visual, auditory or tactile), visuomotor training such as prism adaptation, structured exploration tasks including visual scanning therapy, non-invasive brain stimulation and technology-enhanced approaches. Virtual reality platforms and computerised assessment tools have emerged to deliver immersive, ecologically valid tasks while providing precise metrics of performance. Rehabilitation is most effective when tailored to individual profiles of egocentric versus allocentric neglect, lesion location and co-occurring deficits. Multimodal programmes that combine sensory feedback, motor engagement and cognitive tasks show promise in amplifying neuroplastic changes. Longitudinal studies indicate that gains in spatial exploration translate into improvements in activities of daily living and quality of life. A growing interest in single-case experimental designs reflects the heterogeneity of neglect and the need for rigorous, personalised efficacy trials. Current challenges include optimising dosage and timing of interventions, identifying predictors of treatment response and integrating novel biomarkers such as functional imaging or electrophysiological measures to refine rehabilitation strategies.
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Cognitive Rehabilitation for Unilateral Spatial Neglect publication trend
The graph below shows the total number of articles in cognitive rehabilitation for unilateral spatial neglect across all publications each year (not limited to Nature Index journals).
Technical terms
Egocentric neglect: A failure to attend to the contralesional side of space relative to one’s own body midline.
Allocentric neglect: A deficit in attending to one side of individual objects, regardless of their position in space.
Prism adaptation: A sensorimotor technique in which prism lenses shift the visual field laterally, inducing compensatory motor adjustments that generalise to spatial attention.
Non-invasive brain stimulation: Techniques such as repetitive transcranial magnetic stimulation or transcranial direct current stimulation used to modulate cortical excitability and support rehabilitation.
Virtual reality rehabilitation: The use of computer-generated environments that enable immersive or semi-immersive interactions to assess and train spatial attention in controlled, realistic settings.
References
- Virtual reality rehabilitation for unilateral spatial neglect: A systematic review of immersive, semi-immersive and non-immersive techniques. Neuroscience & Biobehavioral Reviews (2023).
- Multimodal mapping of spatial attention for unilateral spatial neglect in VR: a proof of concept study using eye-tracking and mobile EEG. Virtual Reality (2025).
- Advances in the Rehabilitation of Hemispatial Inattention. Current Neurology and Neuroscience Reports (2023).
- Predicting Functional Outcome after Stroke: The Influence of Neglect on Basic Activities in Daily Living. Frontiers in Human Neuroscience (2013).
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