Prisms and neglect: What have we learned?

Since Rossetti et al. (1998) reported that prism adaptation (PA) can lead to a substantial reduction of neglect symptoms PA has become a hot topic in neglect-research. More than 280 articles have been published in this area. Not all of those studies investigated the therapeutic potential of this technique, many studies examined the responsiveness to PA as a way to subdivide neglect into separate subsyndromes, other studies focussed on the process of PA itself in an effort to illuminate its underlying neurobiological mechanisms. In this article we will review research in all of these three areas to determine whether and to what extent research on PA in neglect patients has fulfilled its promise as a new way to improve the treatment of neglect, enhance our understanding of this complex syndrome and provide new insights into the neurobiology of sensorimotor learning.

► Prism adaptation provides an effective treatment for neglect but only when applied in multiple sessions.
► Not all aspects of neglect benefit to the same extent from prism adaptation.
► Abnormalities of prism adaptation in neglect suggest a role of the inferior parietal cortex in error-detection.
► Research on prism adaptation in neglect has prompted more questions than answers.