Comparison of Prism Adaptation Effects in Children, Younger Adults, and Older Adults

Research Objectives Spatial neglect is a common attention disorder after stroke. It is important to develop treatment plans that can be used across the lifespan. Prism adaptation is a promising treatment for spatial neglect. This study is the first to investigate prism adaptation effects across the lifespan as a first step towards the validation of a home-friendly protocol (Peg-the-Mole app). Design This study used a mixed-model design. Participants were randomly assigned to the use of the Peg-the-Mole app with 15-degree rightward deviating goggles (experimental condition) or 5-degree rightward deviating goggles (active control condition). Each participant alternated between using the app with prism and clear goggles to allow for repeated adaptation. Setting The study was conducted in a research laboratory at Acadia University. Participants 128 healthy participants were enrolled in the study. Forty participants were between the ages of 8 to 13 (child group), 44 were between the ages of 18 and 30 (younger adult group), and 44 were between the ages of 60 and 80 (older adult group). Interventions The exposure task was an interactive software (Peg-the-Mole). Participants performed pointing movements towards a Surface Pro after being instructed to rapidly touch the location where a cartoon mole holding a bull's eye target was presented on the screen. Participants completed 3 blocks of 63 adaptation trials (with prism goggles) and 2 blocks of deadaptation trials (with sham goggles). Main Outcome Measures A proprioceptive-guided pointing straight ahead task, a proprioceptive-and-visual pointing straight ahead task, and a balance task were administered before and after each exposure block. Results Post prism adaptation, children experienced larger after-effects compared to younger and older adults (p < 0.05). During Peg-the-Mole, younger adults experienced larger direct effects and steeper adaptation rates compared to children and older adults. Conclusions Slower visuomotor learning may ultimately result in larger remapping process, which has important implications for the use of the Peg-the-Mole app as a treatment for spatial neglect across the lifespan. Author(s) Disclosures No conflict of interest. Spatial neglect is a common attention disorder after stroke. It is important to develop treatment plans that can be used across the lifespan. Prism adaptation is a promising treatment for spatial neglect. This study is the first to investigate prism adaptation effects across the lifespan as a first step towards the validation of a home-friendly protocol (Peg-the-Mole app). This study used a mixed-model design. Participants were randomly assigned to the use of the Peg-the-Mole app with 15-degree rightward deviating goggles (experimental condition) or 5-degree rightward deviating goggles (active control condition). Each participant alternated between using the app with prism and clear goggles to allow for repeated adaptation. The study was conducted in a research laboratory at Acadia University. 128 healthy participants were enrolled in the study. Forty participants were between the ages of 8 to 13 (child group), 44 were between the ages of 18 and 30 (younger adult group), and 44 were between the ages of 60 and 80 (older adult group). The exposure task was an interactive software (Peg-the-Mole). Participants performed pointing movements towards a Surface Pro after being instructed to rapidly touch the location where a cartoon mole holding a bull's eye target was presented on the screen. Participants completed 3 blocks of 63 adaptation trials (with prism goggles) and 2 blocks of deadaptation trials (with sham goggles). A proprioceptive-guided pointing straight ahead task, a proprioceptive-and-visual pointing straight ahead task, and a balance task were administered before and after each exposure block. Post prism adaptation, children experienced larger after-effects compared to younger and older adults (p < 0.05). During Peg-the-Mole, younger adults experienced larger direct effects and steeper adaptation rates compared to children and older adults. Slower visuomotor learning may ultimately result in larger remapping process, which has important implications for the use of the Peg-the-Mole app as a treatment for spatial neglect across the lifespan.