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Title 半側空間無視に対する最新のリハビリテーション治療
Subtitle 特集 / 脳血管障害の診断・治療の進歩とリハビリテーション診療
Authors 辻本憲吾*1, 水野勝広*2
Authors (kana) つじもとけんご
Organization *1国立精神・神経医療研究センター身体リハビリテーション部, 研究員, *2部長
Journal MB Medical Rehabilitation
Volume
Number 264
Page 35-43
Year/Month 2021 / 8
Article 報告
Publisher 全日本病院出版会
Abstract 「Abstract」半側空間無視は損傷半球と反対側の空間の刺激に対する反応の低下または欠如が認められる疾患である. 右半球損傷の50〜70%の患者に出現し, 無視症状が残存していることで自宅復帰が困難になる可能性が高く, 日常生活において重大な支障をきたす可能性のある疾患である. 近年のイメージング技術の発展により, 現在では, 腹側注意経路の失調による左右半球間の不均衡が原因であることが最も有力な説である. さらに, 急性期と維持期では, 神経機構が異なることが明らかになっている. 半側空間無視に対する評価は, 机上評価(Behavioral Inattention Test; BIT)と観察評価(Catherine Bergego Scale; CBSやKessler Foundation Neglect Assessment Process; KF-NAP)が一般的であるが, サブタイプ別に評価することも重要となってくる. リハビリテーションは過去に様々な手法が提唱されている. 現在の最も効果があるリハビリテーションとしてプリズム適応療法, 経頭蓋磁気刺激が報告されている. また, 近年ではvirtual reality(VR)を用いたリハビリテーションも提唱されている.
Practice 医療技術
Keywords 半側空間無視(unilateral spatial neglect;USN), リハビリテーション(rehabilitation), プリズム適応(prism adaptation), 経頭蓋磁気刺激(transcranial magnetic stimulation), 仮想空間(virtual reality;VR)
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参考文献

  • 1) Heilman KM, et al: Neglect and related disorders. In Heilman KM, & Valenstain E (eds.), Clinical neurophysiology, pp.279e336, Oxford University Press, 1993.
  • 2) Ringman JM, et al: Frequency, risk factors, anatomy, and course of unilateral neglect in an acute stroke cohort. Neurology, 63:468-474, 2004.
  • 3) Chen P, et al: Impact of Spatial Neglect on Stroke Rehabilitation: Evidence From the Setting of an Inpatient Rehabilitation Facility. Arch Phys Med Rehabil, 96(8):1458-1466, 2015.
    pubmed
  • 4) Kinsbourne M: Mechanisms of unilateral neglect. Advances in psychology, 45:69-86, 1987.
  • 5) Yoshida T, et al: Influence of right versus left unilateral spatial neglect on the functional recovery after rehabilitation in sub-acute stroke patients. Neuropsychol Rehabil, 23:1-22, 2020.
残りの39件を表示する
  • 6) Karnath HO, Rorden C: The anatomy of spatial neglect. Neuropsychologia, 6(9):2166-2171, 2012.
  • 7) Doricchi F, Incoccia C. Seeing only the right half of the forest but cutting down all the trees? Nature, 394(6688):75-78, 1998.
    pubmed
  • 8) Husain M, Rorden C: Non-spatially lateralized mechanisms in hemispatial neglect. Nat Rev Neurosci, 4(1):26-36, 2003.
    pubmed
  • 9) Bisiach E, Luzzatti C: Unilateral neglect of representational space. Cortex, 14:129-133, 1978.
    pubmed
  • 10) Tsujimoto K, et al: Right as well as left unilateral spatial neglect influences rehabilitation outcomes and its recovery is important for determining discharge destination in subacute stroke patients. Eur J Phys Rehab Med, 56(1):5-13, 2020.
  • 11) Corbetta M, Shulman GL: Spatial Neglect and Attention Networks. Annu Rev Neurosci, 34:569-599, 2011.
    pubmed
  • 12) Schotten M, et al: A Lateralized Brain Network for Visuospatial Attention Supplementary Methods and Results. Nat Neurosci, 14:1245-1247, 2011.
  • 13) Chotten M, et al: Monkey to human comparative anatomy of the frontal lobe association tracts. Cortex, 48(1):82-96, 2012.
  • 14) Driver J, et al: Parietal neglect and visual awareness. Nat Neurosci, 1:17-22, 1998.
  • 15) Karnath HO, et al: Spatial awareness is a function of the temporal not the posterior parietal lobe. Nature, 411:950-953, 2001.
  • 16) Doricchi F, et al: The anatomy of neglect without hemianopia: a key role for parietal-frontal disconnection? Neuroreport, 14:2239-2243, 2003.
    pubmed
  • 17) He BJ, et al: Breakdown of Functional Connectivity in Frontoparietal Networks Underlies Behavioral Deficits in Spatial Neglect. Neuron, 53(6):905-918, 2007.
    pubmed
  • 18) Ramsey LE, et al: Normalization of network connectivity in hemispatial neglect recovery. Ann Neurol, 80(1):127-141, 2016.
    pubmed
  • 19) Wilson B, et al: Behavioral Inattention Test. Thames Valley Test Company, 1987.
  • 20) Schindler I, Kerjhoff G: Head and trunk orientation modulate visual neglect. NeuroReport, 8(12):2681-2685, 1997.
  • 21) Bergego C, et al: Validation dune echelle d'evaluation fonctionnelle de I'heminegligence dans la vie quotidienne: I'echelle CB. Ann Readapt Med Phys, 38:183-189, 1995.
  • 22) Azouvi P, et al: Functional consequences and awareness of unilateral neglect: study of an evaluation scale. Neurophychol Rehabil, 6:133-150, 2003.
  • 23) Chen P, et al: Kessler Foundation Neglect Assessment Process Uniquely Measures Spatial Neglect During Activities of Daily Living, Arch Phys Med Rehabil, 96:869-876, 2015.
    pubmed
  • 24) Chen P, Hreha K: Kessler Foundation Neglect Assessment Process KF-NAP(TM) 2015 Manual. 2015. [https://kesslerfoundation.org/sites/default/files/files/KF-NAP_2015_Manual.pdf]
  • 25) Ota H, et al: Dissociation of body-centered and stimulus-centered reprecsentations in unilateral neglect. Neurology, 57(11):2064-2069, 2001.
    pubmed
  • 26) Vuilleumier P, et al: Near and far visual space in unilateral neglect. Ann Neurol, 43:406-410, 1998.
    pubmed
  • 27) Berti A, Frassinetti F: When far becomes near: Remapping of space by tool use. J Cogn Neurosci, 1:415-420, 2000.
  • 28) Aimola L, et al: Near and far space neglect: Task sensitivity and anatomical substrates. Neuropsychologia, 50(6):1115-1123, 2012.
    pubmed
  • 29) Maravita A, Romano D: The parietal lobe and tool use. Handb Clin Neurol, 151:481-498, 2019.
  • 30) Takamura Y, et al: Intentional gaze shift to neglected space: a compensatory strategy during recovery after unilateral spatial neglect. Brain, 139(11):2970-2982, 2016.
    pubmed
  • 31) Luaute J, et al: Visuo-spatial neglect: A systematic review of current interventions and their effectiveness. Neurosci Biobehav Rev, 30(7):961-982, 2006.
    pubmed
  • 32) Gammeri R, et al: Unilateral spatial neglect after stroke: Current insights. Neuropsychiatr Dis Treat, 16:131-152, 2020.
    pubmed
  • 33) Rossetti Y, et al: Prism adaptation to a rightward optical deviation rehabilitates left hemispatial neglect. Nature, 395:166-169, 1998.
    pubmed
  • 34) Mizuno K, et al: Prism adaptation therapy enhances rehabilitation of stroke patients with unilateral spatial neglect: A randomized, controlled trial. Neurorehabil Neurol Repair, 25(8):711-720, 2011.
  • 35) Shiraishi H, et al: Prism intervention helped sustainability of effects and ADL performances in chronic hemispatial neglect: a follow-up study. Neuro Rehabilitation, 27:165-172, 2010.
    pubmed
  • 36) Saj A, et al: Prism adaptation enhances activity of intact fronto-parietal areas in both hemispheres in neglect patients. Cortex, 49(1):107-119, 2013.
    pubmed
  • 37) Tsujimoto K, et al: Prism adaptation changes resting-state functional connectivity in the dorsal stream of visual attention networks in healthy adults: A fMRI study. Cortex, 119:594-605, 2019.
    pubmed
  • 38) Agosta S, et al: Contralesional rTMS relieves visual extinction in chronic stroke. Neuropsychologia, 62:269-276, 2014.
    pubmed
  • 39) Cazzoli D, et al: Theta burst stimulation reduces disability during the activities of daily living in spatial neglect. Brain, 135(11):3426-3439, 2012.
  • 40) Nyffeler T, et al: Theta burst stimulation in neglect after stroke: Functional outcome and response variability origins. Brain, 142(4):992-1008, 2019.
    pubmed
  • 41) Bonni S, et al: Theta burst stimulation improves visuo-spatial attention in a patient with traumatic brain injury. Neurological Scineces, 34(11):2053-2056, 2013.
  • 42) Rabuffetti M, et al: Spatio-temporal features of visual exploration in unilaterally brain-damaged subjects with or without neglect: results from a touchscreen test. PLoS One, 7:2, 2013.
    pubmed
  • 43) Kim YM, et al: The effect of virtual reality training on unilateral spatial neglect in stroke patients. Ann Rehabil Med, 35(3):309, 2011.
    pubmed
  • 44) Fordell H, et al: RehAtt-scanning training for neglect enhanced by multi-sensory stimulation in virtual reality. Top Stroke Rehabil, 23(3):191-199, 2016.
    pubmed
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