Clinical NeuroscienceDevelopment of a new computerized prism adaptation procedure for visuo-spatial neglect

- We have developed a new computerized prism adaptation procedure (Peg-the-Mole, PTM).
- PTM is easily standardized and could be carried out at home by patients.
- PTM and the typical prism procedure were equally effective at similar doses.
- PTM has a greater potential for increased treatment adherence and intensity.
- PTM may be a promising alternative rehabilitation technique for neglect.

BackgroundPrism adaptation (PA) is a promising rehabilitation technique for visuo-spatial neglect. However, PA effects are often inconsistent across studies and the clinical application of this technique has been limited. The purpose of the present studies was to validate an easily standardized, home-friendly, and game-like PA technique (Peg-the-Mole) with healthy participants as a first step toward clinical development.New methodIn study 1, we used Peg-the-Mole with 32 participants wearing prism or sham goggles to investigate whether this procedure can induce significant after-effects on midline judgment and pointing tasks. In study 2, we compared Peg-the-Mole to a typical PA protocol in 42 participants for after-effects and level of enjoyment and to determine if the after-effects generalize to a throwing task.Results and comparison with existing methodStudy 1 showed that Peg-the-Mole induced significant after-effects on all outcome measures. Study 2 demonstrated that after-effects induced by Peg-the-Mole were equivalent to those induced by the typical PA procedure on all outcome measures. Peg-the-Mole was rated as more enjoyable than the typical procedure.ConclusionsPeg-the-Mole is a new computerized PA procedure that can be easily standardized and successfully used to induce significant after-effects. The present findings demonstrate that alterations can be made to the typical PA procedure to make it easier to use and more enjoyable, factors that could increase treatment availability, adherence and intensity.