Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Prism adaptation to a rightward optical deviation rehabilitates left hemispatial neglect


A large proportion of right-hemisphere stroke patients show hemispatial neglect—a neurological deficit of perception, attention, representation, and/or performing actions within their left-sided space1, inducing many functional debilitating effects on everyday life, and responsible for poor functional recovery and ability to benefit from treatment2. The frequent parietal locus of the lesion producing neglect reflects the impairment of coordinate transformation used by the nervous system to represent extrapersonal space. Given that adaptation to a visual distortion can provide an efficient way to stimulate neural structures responsible for the transformation of sensorimotor coordinates, the aim of our study was to investigate the effect of prism adaptation on various neglect symptoms, including the pathological shift of the subjective midline to the right. All patients exposed to the optical shift of the visual field to the right were improved on their manual body-midline demonstration and on classical neuropsychological tests. Unlike other physiological manipulations used to improve neglect, this improvement lasted for at least two hours after prism removal and thus could be useful in rehabilitation programmes. The positive effect found for both sensorimotor and more cognitive spatial functions suggests that they share or depend on a common level of space representation linked to multisensory integration.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1: Midline demonstrations.
Figure 2: Copying test.
Figure 3: Line cancellation and bisection.


  1. 1

    Heilman, K. M., Watson, R. T. & Valenstein, E. in Clinical Neuropsychology (eds Heilman, K. M. & Valenstein, E.) 243–293 (Oxford University Press, New York, (1985)).

    Google Scholar 

  2. 2

    Halligan, P. W., Marshall, J. C. & Wade, D. T. Visuospatial neglect: underlying factors and test sensitivity. Lancet 2, 908–911 (1989).

    CAS  Article  Google Scholar 

  3. 3

    Rubens, A. B. Caloric stimulation and unilateral visual neglect. Neurology 35, 1019–1024 (1985).

    CAS  Article  Google Scholar 

  4. 4

    Rode, G. & Perenin, M. T. Temporary remission of representational hemineglect through vestibular stimulation. Neuroreport 5, 869–872 (1994).

    CAS  Article  Google Scholar 

  5. 5

    Karnath, H. O. Subjective body orientation in neglect and the interactive contribution of neck muscle proprioception and vestibular stimulation. Brain 117, 1001–1012 (1994).

    Article  Google Scholar 

  6. 6

    Pizzamiglio, L., Frasca, R., Guariglia, C., Incoccia, C. & Antonucci, G. Effects of optokinetic stimulation in patients with visual neglect. Cortex 26, 535–540 (1990).

    CAS  Article  Google Scholar 

  7. 7

    Walker, R., Young, A. W. & Lincoln, N. B. Eye patching and the rehabilitation of visual neglect. Neuropsychol. Rehab. 6, 219–231 (1996).

    Article  Google Scholar 

  8. 8

    Perenin, M. T. in Parietal Lobe Contribution to Orientation in 3D Space (eds Thier, P. & Karnath, H. O.) 298–308 (Springer, Heidelberg, (1997)).

    Google Scholar 

  9. 9

    Redding, G. M. & Wallace, B. Adaptive spatial alignment and strategic perceptual-motor control. J.Exp. Psychol. Hum. Percept. Perform. 22, 379–394 (1996).

    CAS  Article  Google Scholar 

  10. 10

    Rossetti, Y., Koga, K. & Mano, T. Prismatic displacement of vision induces transient changes in the timing of eye-hand coordination. Percept. Psychophys. 54, 355–364 (1993).

    CAS  Article  Google Scholar 

  11. 11

    Sugita, Y. Global plasticity in adult visual cortex following reversal of visual input. Nature 380, 523–526 (1996).

    ADS  CAS  Article  Google Scholar 

  12. 12

    Halligan, P. W. & Cockburn, J. M. Cognitive sequelae of stroke: visuospatial and memory disorders. Crit. Rev. Phys. Rehab. Med. 5, 57–81 (1993).

    Google Scholar 

  13. 13

    Schenckenberg, T., Bradford, D. C. & Ajax, E. T. Line bisection with neurologic impairment. Neurology 30, 509–517 (1980).

    Article  Google Scholar 

  14. 14

    Albert, M. L. Asimple test for visual neglect. Neurology 23, 658–664 (1973).

    CAS  Article  Google Scholar 

  15. 15

    Gainotti, G., Messerli, P. & Tissot, R. Qualitative analysis of unilateral spatial neglect in relation to laterality of cerebral lesions. J. Neurol. Neurosurg. Psychiat. 35, 545–550 (1972).

    CAS  Article  Google Scholar 

  16. 16

    Chokron, S. & Bartolomeo, P. Patterns of dissociation between left hemineglect and deviation of the egocentric reference. Neuropsychologia 35, 1503–1508 (1997).

    CAS  Article  Google Scholar 

  17. 17

    Farné, A., Ponti, F. & Ladavas, E. In search of biased egocentric reference frames in neglect. Neuropsychologia 247, 611–623 (1998).

    Article  Google Scholar 

  18. 18

    Vallar, G., Guariglia, C. & Rusconi, M. L. in Parietal Lobe Contribution to Orientation in 3D Space (eds Thier, P. & Karnath, H. O.) 555–579 (Springer, Heidelberg, (1997)).

    Google Scholar 

  19. 19

    Clower, D. al. Role of posterior parietal cortex in the recalibration of visually guided reaching. Nature 383, 618–621 (1996).

    ADS  CAS  Article  Google Scholar 

  20. 20

    Rossi, P. W., Kheyfets, S. & Reding, M. J. Fresnel prisms improve visual perception in stroke patients with homonymous hemianopia or unilateral visual neglect. Neurology 40, 1597–1599 (1990).

    CAS  Article  Google Scholar 

  21. 21

    Coello, Y., Orliaguet, J.-P. & Prablanc, C. Pointing movement in an artificial perturbing inertial field: aprospective paradigm for motor control study. Neuropsychologia 34, 879–892 (1996).

    CAS  Article  Google Scholar 

  22. 22

    Jeannerod, M. & Rossetti, Y. in Visual Perceptual Defects (ed. Kennard, C.) 439–460 (Tindall, London, (1993)).

    Google Scholar 

  23. 23

    Sakata, H. & Taira, M. Parietal control of hand action. Curr. Opin. Neurobiol. 4, 847–856 (1994).

    CAS  Article  Google Scholar 

  24. 24

    Mattingley, J., Hussain, M., Rorden, C., Kennard, C. & Driver, J. Motor role of human inferior parietal lobe revealed in unilateral neglect patients. Nature 392, 179–182 (1998).

    ADS  CAS  Article  Google Scholar 

Download references


We thank M. Cabanac, D. Clower, L. Goffart, P. Halligan, J. Mattingley, C. Prablanc, A. Vighetto for their comments on the manuscript, and P. Monjaud and C. Urquizar for technical assistance. This work was supported by the Région Rhône-Alpes, France, by the Hospices Civils de Lyon and by Elypses. A.F. was awarded a predoctoral fellowship by the European Neuroscience Programme, European Science Foundation.

Author information



Corresponding author

Correspondence to Yves Rossetti.

Supplementary Information

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Rossetti, Y., Rode, G., Pisella, L. et al. Prism adaptation to a rightward optical deviation rehabilitates left hemispatial neglect. Nature 395, 166–169 (1998).

Download citation

Further reading


By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing