Neurobiologische Grundlagen des Neglects: Implikationen für neue Therapieansätze

Zusammenfassung

Neglect ist eine durch eine fokale Hirnschädigung hervorgerufene räumliche Wahrnehmungsstörung von hoher klinischer Relevanz für die Rehabilitation von Schlaganfallpatienten. Die für Neglect charakteristische Vernachlässigung kontraläsionaler Reize in verschiedenen sensorischen Modalitäten wird heute insbesondere auf Störungen der räumlichen Aufmerksamkeit, des räumlichen Arbeitsgedächtnisses, der Raumrepräsentation in verschiedenen räumlichen Bezugssystemen sowie der Initiierung kontralateraler Bewegungen zurückgeführt. In den letzten Jahrzehnten wurden zahlreiche Interventionsstrategien entwickelt, um Neglect-Symptome bei Schlaganfall-Patienten zu reduzieren, wobei bislang für kaum eine Maßnahme eindeutige Belege einer alltagsrelevanten Funktionsverbesserung bei Neglect-Patienten vorliegen. Die Erforschung von Prädiktoren der Funktionserholung und des Rehabilitationserfolgs stellt somit eine wesentliche Herausforderung zukünftiger Forschungsarbeiten dar.

Abstract

Neglect is characterised by a clinically relevant impairment of spatial perception and awareness observed after focal brain damage. The neglect-specific deficit in responding to contralesional stimuli in various sensory modalities is most commonly explained by impairments of spatial attention, spatial working memory, impaired spatial reference frames and lateralised movement initiation. Many neglect interventions have been developed in the last decades to alleviate symptoms of neglect in stroke patients. However, hardly any of these methods has been proven to significantly ameliorate the patient’s deficits in everyday activities. Thus, the identification of predictors for recovery of function and of the success of rehabilitative measures provides a major challenge for future research on neglect.

Schlüsselwörter

Schlaganfall - räumliche Kognition - Aufmerksamkeit - Neuropsychologie - Neurostimulation - Neuropharmakologie

Keywords

stroke - spatial cognition - attention - neuropsychology - neurostimulation - neuropharmacology

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