Abstract Details

Title Classifying Patients with Spatial Neglect by "Aiming" Versus "Where" Spatial Bias May Explain Differential Response to Bromocriptine Treatment

Topic Neural Repair/Rehabilitation

Presentation(s) P03 - (-)

Poster/Presentation
Number 261

Objective

Background BACKGROUND: Based on animal studies (Marshall, 1979), Fleet et al. (1987) reported bromocriptine improved spatial neglect. However, in other studies (Grujic et al., 1998; Barrett et al., 1999) neglect symptoms worsened after treatment. We wished to learn whether "where" versus "aiming" spatial bias subgroups may predict bromocriptine treatment response, due to differences in brain network impairment (Adair and Barrett, 2008).

Design/Methods DESIGN/METHODS: 10 spatial neglect patients (60.2 ± 11.06 years, range = 43-83) completed a computerized line bisection test, and were classified into three bias categories: "aiming"-only (n=4), "where"-only (n=3) and "aiming + where" (n=3). All patients were administered gradually increasing levels of bromocriptine, from 1.5mg to 15mg, over 8 sessions in a 7-week period during which functional improvement was assessed with the Catherine Bergego Scale (CBS). Controlling for baseline CBS, we used multilevel modeling (MLM) to assess patients' CBS improvement trajectories in each of the three bias categories.

Results RESULTS: MLM revealed that compared with "where"-only, "aiming"-only group demonstrated more improvement (b=-.21, p=0.008) and "aiming + where" group did not improve significantly (b=-0.001, p>0.05). Additionally, baseline functional status significantly predicted CBS improvement over sessions (b=0.73, p=0.001).

Conclusions CONCLUSIONS: Classifying spatial neglect may be vital to interpreting rehabilitation outcomes and treatment studies. In this group study, larger than those performed previously, patients with "aiming" bias appeared to respond favorably to bromocriptine. However, "aiming" neglect patients may also have had milder neglect than those with "where" bias. Therefore, identifying "aiming" bias may also identify milder forms of neglect likely to respond to bromocriptine. Future studies with more bias-characterized patients are indicated.

Authors/Disclosures
Amit Chaudhari, MD, PhD (UCLA) PRESENTER	No disclosure on file
Priyanka P. Shah-Basak, PhD (Medical College of Wisconsin)	The institution of Dr. Shah-Basak has received research support from NIH NIDCD. The institution of Dr. Shah-Basak has received research support from NIH NIDCD.
	No disclosure on file
	No disclosure on file
	No disclosure on file
A. M. Barrett, MD, FAAN (UMass Memorial)	The institution of Dr. Barrett has received research support from Veterans Health Association. The institution of Dr. Barrett has received research support from National Institutes of Health. The institution of Dr. Barrett has received research support from Mabel H Flory Trust. Dr. Barrett has received personal compensation in the range of $0-$499 for serving as a author, chapter with WebMD. Dr. Barrett has received personal compensation in the range of $10,000-$49,999 for serving as a scientific advisor with Winifred Masterson Burke Foundation.

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