Yuka Kasuya-Ueba ^1,2* Koji Maeda ³

• ¹ Kōchi University, Kochi, Kōchi, Japan
• ² Department of Rehabilitation, Shiragikuen Hospital, Kochi, Kōchi, Japan
• ³ Shiragikuen Hospital, Kochi, Kōchi, Japan

A 69-year-old right-handed man, who initially suffered a stroke 8 years ago and experienced two recurrences since then, presented with right hemiplegia and left hemispatial neglect as a poststroke syndrome in the chronic phase. This report demonstrates the use of active musical instrument playing with Musical Neglect Training (MNT ® ) to improve severe left-side neglect and activities of daily living (ADLs). In addition to physical and occupational therapy, individual MNT ® was incorporated into the patient's rehabilitation plan to improve his hemispatial neglect. At the initiation of the intervention, the number of uncrossed lines on the line cancellation test was 33 out of 40, and his Mini-Mental State Examination score was 17. Regarding ADLs, a disturbance in the self-centered space was observed, especially during eating and wheelchair operations. Over the course of 18 months of weekly individual MNT ® , a remarkable improvement was observed in the line cancellation test (number of uncrossed lines=4) score and in ADLs. Follow-up tests showed that the effects of the intervention lasted at least 6 months. This is the first reported case demonstrating long-term effects observed at 6 months after an 18-month intervention period employing MNT ® in a patient with severe chronic persistent hemispatial neglect. While rigorous studies are needed, our findings encourage further investigation of the benefits of MNT ® interventions in post-stroke rehabilitation. In summary, long-term intervention involving active musical instrument playing, using auditory stimulus cues, significantly improved the severe symptoms of left spatial neglect in a patient with right hemiplegia, even during the chronic phase of recovery.