Neck muscle vibration improves neglect symptoms in right-hemispheric stroke patients

BACKGROUND AND AIM: Unilateral spatial neglect (UN) impairs patients' ability to detect and respond to stimuli on the contralesional side, severely limiting functional recovery after right-hemispheric stroke. Neck muscle vibration (NMV) has been shown to be a bottom-up, proprioceptive intervention to modulate spatial neglect. Although preliminary studies found promising effects, the isolated efficacy of NMV for neglect rehabilitation has not yet been tested in a randomized, blinded controlled trial. This study aimed to evaluate whether NMV alone improves neglect symptoms and activities of daily living (ADL). METHODS: Twenty patients with right-hemispheric stroke and UN were randomly assigned to receive either active or placebo NMV (combined, but not simultaneously with computer-based training) over 2 weeks (5 sessions/week, 20 minutes/day). In the computer training, the placebo NMV group completed neglect-specific modules (standard neglect therapy [SNT], e.g., visual exploration training), while the active NMV group performed only general cognitive tasks unrelated to neglect. This allowed the isolated effect of NMV to be examined. Assessments included standard neglect diagnostics (e.g., Letter Cancellation), the Free Exploration Test (FET), and 2 ADL-based measures (NET, CBS), conducted before, immediately after, and (NMV group only) 1 month post-treatment. RESULTS: The active NMV group showed significant improvements in 3 of 4 standard neglect tests, exploration behavior (FET), and ADL performance, with effects remaining stable at 1-month follow-up. The SNT group with placebo NMV showed comparable gains in ADL outcomes but improved in 1 standard neglect test only. Between-group analyses revealed no statistically significant differences, suggesting similar efficacy of both interventions. CONCLUSION: NMV alone yields clinically meaningful and lasting improvements in neglect symptoms and ADL, comparable to SNT. Its passive nature makes it a promising tool, particularly for early rehabilitation.