Theta burst stimulation - A possible therapy for neglectpatients?

Hemispatial neglect is a frequent neurological disorder after right hemispheric stroke and has a strong negative influence on rehabilitation outcome. The precise mechanisms of action, the duration of the effects, and the relevance for the activities of daily living of current therapeutic approaches are still uncertain. Interhemispheric balance has been shown to play a central role in the occurrence and persistence of hemispatial neglect. According to the model, after a right hemispheric lesion, the contralesional, intact hemisphere undergoes a pathological hyperactivity, biasing attention towards the ipsilesional space. The reduction of this pathological hyperactivity by means of conventional inhibitory transcranial magnetic stimulation protocols is known to have only short-term positive effects on neglect symptoms. Newly developed stimulation protocols such as theta burst stimulation, characterised by short stimulation times, have been shown to induce long-lasting behavioural effects, which can be disproportionately prolonged by means of repeated applications. Therefore, theta burst stimulation seems to be a viable and effective complementary approach in the therapy of patients suffering from hemispatial neglect.