Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Lyon Neuroscience Research Center, ImpAct (Integrative, Multisensory, Perception, Action & Cognition) team INSERM U1028, CNRS UMR5292, University Lyon 1, Bron, France; Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
Lyon Neuroscience Research Center, ImpAct (Integrative, Multisensory, Perception, Action & Cognition) team INSERM U1028, CNRS UMR5292, University Lyon 1, Bron, France; Hospices Civils de Lyon, Mouvement et Handicap, Hôpital Henry Gabrielle, Saint Genis-Laval, France
Helena Cousijn
Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
Jamie Near
Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
Sophie Jacquin-Courtois
Lyon Neuroscience Research Center, ImpAct (Integrative, Multisensory, Perception, Action & Cognition) team INSERM U1028, CNRS UMR5292, University Lyon 1, Bron, France; Hospices Civils de Lyon, Service de Rééducation Neurologique, Hôpital Henry Gabrielle, Saint Genis-Laval, France
Heidi Johansen-Berg
Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
Gilles Rode
Lyon Neuroscience Research Center, ImpAct (Integrative, Multisensory, Perception, Action & Cognition) team INSERM U1028, CNRS UMR5292, University Lyon 1, Bron, France; Hospices Civils de Lyon, Service de Rééducation Neurologique, Hôpital Henry Gabrielle, Saint Genis-Laval, France
Lyon Neuroscience Research Center, ImpAct (Integrative, Multisensory, Perception, Action & Cognition) team INSERM U1028, CNRS UMR5292, University Lyon 1, Bron, France; Hospices Civils de Lyon, Mouvement et Handicap, Hôpital Henry Gabrielle, Saint Genis-Laval, France
Right brain injury causes visual neglect - lost awareness of left space. During prism adaptation therapy, patients adapt to a rightward optical shift by recalibrating right arm movements leftward. This can improve left neglect, but the benefit of a single session is transient (~1 day). Here we show that tonic disinhibition of left motor cortex during prism adaptation enhances consolidation, stabilizing both sensorimotor and cognitive prism after-effects. In three longitudinal patient case series, just 20 min of combined stimulation/adaptation caused persistent cognitive after-effects (neglect improvement) that lasted throughout follow-up (18–46 days). Moreover, adaptation without stimulation was ineffective. Thus stimulation reversed treatment resistance in chronic visual neglect. These findings challenge consensus that because the left hemisphere in neglect is pathologically over-excited it ought to be suppressed. Excitation of left sensorimotor circuits, during an adaptive cognitive state, can unmask latent plastic potential that durably improves resistant visual attention deficits after brain injury.
