Summary of the S2k guideline "Diagnosis and Therapy of Neglect and Other Disorders of Spatial Cognition" (AWMF-030/126)

In the newly revised guideline, the proven exploration training in treating spatial neglect has been supplemented by suggestions for the therapeutic procedure for different degrees of severity of spatial neglect, resulting in a respective reduction in time. Furthermore, the exploration training currently undergoes interesting enhancements by applying "augmented reality" and "virtual reality" procedures. Further recommendations for treating spatial neglect include training using slow smooth pursuit eye movements to the contralateral side and neck muscle vibration. Among the noninvasive transcranial brain stimulation procedures, continuous theta burst stimulation (cTBS) protocol has proved effective - if combined with at least one other neglect training procedure (e. g., exploration training). For treatment of the Pusher syndrome, different groups have successfully used visual feedback training and robot-assisted gait training. The situation is more problematic for procedures used for treating the other disorders of spatial cognition discussed in the guideline (Balint syndrome, simultanagnosia, optic ataxia, disorders of visuospatial perception, visuoconstructive disorders, topographic disorders); single-case or small-group studies dominate here. The evaluation of individual, methodologically high-quality, and well-documented therapy studies currently provides the only basis for deriving recommendations for treating this latter group of disorders of spatial cognition.