SUSTAINED ATTENTION TRAINING FOR UNILATERAL NEGLECT - THEORETICAL ANDREHABILITATION IMPLICATIONS

Many studies have shown a co-variation of unilateral neglect with nonl ateralised attentional functions. Recently, Posner has argued that the re are two separate neural systems that influence the posterior attent ional system which is presumed to be impaired in unilateral neglect, n amely, the posterior system itself (located partly in the inferior par ietal lobules) as well as a secondary modulatory sustained attention o r vigilance system. This latter system is linked to the nor-epinephrin e system, which is known to be more strongly represented in the right compared to the left hemisphere of the brain. If this hypothesis is tr ue, then unilateral neglect should be improved by increasing activatio n of the sustained attention system. Eight patients suffering from chr onic left unilateral neglect were trained to sustain their attention b y a self-alerting procedure partially derived from Meichenbaum's self- instructional methods. Using a multiple-baseline-by-function design, a s well as multiple-baseline-by-subject designs, statistically signific ant improvements in unilateral neglect as well in sustained attention were found following onset of sustained attention training, without co rresponding improvements in control measures. Theoretical implications for the attentional underpinnings of unilateral neglect are discussed , as well as the rehabilitation implications of this training procedur e.