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Williams LJ, Loetscher T, Hillier S, Hreha K, Jones J, Bowen A, Kernot J. Identifying spatial neglect - an updated systematic review of the psychometric properties of assessment tools in adults post-stroke. Neuropsychol Rehabil 2025; 35:628-667. [PMID: 38727637 DOI: 10.1080/09602011.2024.2346212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/15/2024] [Indexed: 03/18/2025]
Abstract
Spatial neglect commonly occurs after a stroke, resulting in diverse impacts depending on the type and severity. There are almost 300 tools for assessing neglect, yet there is a lack of knowledge on the psychometric properties of these tools. The objective of this systematic review, registered on Prospero (CRD42021271779), was to determine the quality of the evidence for assessing spatial neglect, categorized by neglect subtype. The following databases were searched on 3rd May 2022 from database inception: Ovid Emcare, Embase, Ovid MEDLINE, APA PsycINFO, Web of Science (SCI-EXPANDED; SSCI; A&HCI; ESCI) and Scopus. All primary peer-reviewed studies (>5 participants) of adults post stroke, reporting any psychometric property of 33 commonly used neglect assessment tools were included. The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) risk of bias tool was used to assess the methodological quality of the studies and summarize the psychometric properties of each tool. 164 articles were included, with a total of 12,463 people with stroke. The general quality of the evidence was poor and no one tool had high-quality evidence of both validity and reliability. Eleven tools show some promise as they meet the minimum criteria for good measurement properties for both validity and reliability.
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Affiliation(s)
- Lindy J Williams
- Innovation IMPlementation and Clinical Translation (IIMPACT) in Health; Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Tobias Loetscher
- Cognitive Ageing and Impairment Neurosciences lab, Justice and Society, North Terrace, University of South Australia, Adelaide, Australia
| | - Susan Hillier
- Innovation IMPlementation and Clinical Translation (IIMPACT) in Health; Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Kimberly Hreha
- Department of Orthopaedic Surgery, Occupational Therapy Doctorate Division, School of Medicine, Duke University, Durham, NC, USA
| | - Jennifer Jones
- The Division of Psychology, Communication and Human Neuroscience, University of Manchester, Manchester, UK
| | - Audrey Bowen
- Geoffrey Jefferson Brain Research Centre and Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Jocelyn Kernot
- Allied Health and Human Performance, University of South Australia, Frome Road, Adelaide, Australia
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Ajana K, Everard G, Lejeune T, Edwards MG. An immersive virtual reality serious game set for the clinical assessment of spatial attention impairments: Effects of avatars on perspective? Technol Health Care 2025:9287329241296380. [PMID: 39973878 DOI: 10.1177/09287329241296380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2025]
Abstract
BACKGROUND Hemineglect (HN) is a post-stroke condition, frequently defined as an impairment in finding spatial targets within an egocentric frame of reference, where the stimulus is coded relative to the self. However, the egocentric reference frame can change with the presence of another person. Immersive virtual reality (IVR) offers several advantages over paper-and-pencil tests typically used to assess HN, such as a realistic and controlled environment, standardised stimulus presentation, and sensitive response acquisition. We developed a new serious game in IVR to assess HN. Here we investigated (1) the feasibility and user experience of this serious game, and (2) the effect of the presence of an avatar on HN. METHODS We first tested a group of 61 control individuals (CI), followed by a group of post-stroke 11 individuals without HN (SI:HN-), 6 with HN (SI:HN+), and 17 resampled age matched group of control individuals (CI). All participants performed the "Peach test", which required them to find and respond to a target presented among distractors, either alone or in the presence of an avatar. We measured response time (RT) and omissions. The SI:HN- and SI:HN + groups also completed a paper-and-pencil test for HN and a user experience questionnaire. RESULTS The first analysis of results with CI showed no differences in responding to the target when in ipsi- compared to contra-lateral spaces, nor in peri- compared to extra-personal spaces. There were also no differences in responding to the target in the no-avatar condition relative to the two avatars conditions. In the second analysis, SI:HN + were slower than SI:HN- and CI. Although an interaction between group and Laterality was predicted, the results showed that there was no Laterality effect for any of the groups. An interaction between group and proximity, showed that both SI groups were slower in the extra- compared to peri-personal spaces. The user experience was globally positively rated by the SI. CONCLUSION We developed a serious game in IVR for the assessment of HN. Although most our findings were inconclusive, the Peach test showed excellent user experience results.Trial registration http://www.clinicaltrials.gov ; Unique identifier: NCT04694833, Date of registration: 11/24/2020.
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Affiliation(s)
- Khawla Ajana
- Psychological Sciences Research Institute, University of Louvain, Louvain-la-Neuve, Belgium
- Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Gauthier Everard
- Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
- Institute of Experimental and Clinical Research, University of Louvain, Brussels, Belgium
| | - Thierry Lejeune
- Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
- Institute of Experimental and Clinical Research, University of Louvain, Brussels, Belgium
- Cliniques universitaires Saint-Luc, Service de médecine physique et réadaptation, Brussels, Belgium
| | - Martin Gareth Edwards
- Psychological Sciences Research Institute, University of Louvain, Louvain-la-Neuve, Belgium
- Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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Hildebrandt H, Notbohm A, Duning T, Schweser I. Is recovery from left-sided neglect based on changes in automatic attention? An auditory event related potentials study. APPLIED NEUROPSYCHOLOGY. ADULT 2025; 32:205-215. [PMID: 36587828 DOI: 10.1080/23279095.2022.2163173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
An automatic spatial attention deficit is the primary deficit in neglect. However, the cognitive processes enabling recovery from neglect have rarely been studied. We used event-related potentials (ERP) to analyze if recovery is based on changes in automatic attention components. Twelve sub-acute patients with left visuospatial neglect were included. They received 3 weeks of intensive treatment. ERPs were recorded using two auditory paradigms: either a tone was presented randomly to the right or left ear (ATP) or as a Posner paradigm (PP) with left to right and vice versa moving cue tones and validly and invalidly cued target tones. Patients improved significantly on neuropsychological tests and neurological scales. For the ATP, no differences were observed related to the side of stimulation, but the auditory PP showed characteristic results, that is, smaller amplitudes for left-sided targets and higher amplitudes for invalid trials. Both paradigms revealed a treatment effect, but no changes were found in the amplitudes for the two target sides, which would be expected if the treatment would affect the automatic attention bias. Recovery from neglect seems not to be associated with changes in the automatic spatial attention bias, arguing that recovery might be due to higher cognitive compensatory processes.
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Affiliation(s)
- Helmut Hildebrandt
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Annika Notbohm
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
| | - Thomas Duning
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
| | - Insa Schweser
- Department of Psychology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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Bahrami Balani A, Bickerton WL. Acquired reading impairment following brain injury. APPLIED NEUROPSYCHOLOGY. ADULT 2025; 32:1-19. [PMID: 36745703 DOI: 10.1080/23279095.2023.2165923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This large-scale patient study investigated the rate, unique signatures associated with acquired reading impairments, its neurocognitive correlates, and long-term outcome in 731 acute stroke patients using the sentence and non-word reading subtests of Birmingham Cognitive Screen (BCoS). The objectives for the study were to explore the (i) potentially different error patterns among adult patients, (ii) associative relationship between the different subclasses of reading impairment and performance in other cognitive domains, and (iii) recovery rates in patients nine months post-lesion compared with their initial performance. The study revealed distinctive reading impairment profiles in patients with left hemisphere (LH) and right hemisphere (RH) lesions. Some interesting associations between reading disorder and other cognitive functions were observed. Nine months post-lesion, both groups showed some recovery in reading performance compared with their baseline performance, but the rate of improvement was higher for the LH group. The study reveals unique reading profiles and impairment patterns among left and right hemisphere lesions. The findings of the study provide a deeper understanding of reading deficits that will inform clinical practice, planning of rehabilitative interventions of brain injured patients, and the scientific community.
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Veronelli L, Vallar G. Left- and right-side unilateral spatial neglect: Hemispheric differences. HANDBOOK OF CLINICAL NEUROLOGY 2025; 208:127-154. [PMID: 40074392 DOI: 10.1016/b978-0-443-15646-5.00025-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2025]
Abstract
Neglect of one side of space, typically contralateral to a lesion of one cerebral hemisphere, is a multicomponent neurologic syndrome. In humans, left neglect after right brain damage is more frequent, severe, or both, than right neglect after left brain damage. Right neglect is behaviorally like left neglect. In the monkey, such a functional asymmetry is not present. In humans, left hemisphere-based spatial systems are weaker, likely due to the coexistence of language and spatial processes. This may account for the lateral asymmetry of neglect, which is present at birth. Except in a few patients, there is no global functional reversal of language and spatial cognition. Left brain-damaged patients often show both aphasia and right neglect, as many right brain-damaged patients with crossed aphasia show left neglect. Lateralized sensory stimulations temporarily improve both left and right neglect. Damage to the posterior parietal lobe (inferior parietal lobule), the temporo-parietal junction, the superior and middle temporal, and to the premotor and prefrontal cortices is associated with contralateral neglect; also, lesions in white matter fiber tracts and subcortical nuclei bring about neglect, with no definite left-right asymmetries.
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Affiliation(s)
- Laura Veronelli
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; MiBTec, University of Milano-Bicocca, Milan, Italy; Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy.
| | - Giuseppe Vallar
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; MiBTec, University of Milano-Bicocca, Milan, Italy.
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Boukrina O, Madden EB, Giordano N, Karim D, Staples R, Graves WW. Targeting Phonology or Semantics to Improve Reading Aloud Response Times and Accuracy: A Case Series Investigation of Stroke Survivors With Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:3263-3295. [PMID: 39146330 DOI: 10.1044/2024_ajslp-23-00364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
PURPOSE Acquired reading deficits, or alexia, affect a significant proportion of individuals with aphasia. We sought to improve treatment for alexia by targeting specific cognitive information-processing components critical to reading (i.e., phonology or semantics). METHOD To target either phonological or semantic processing, we administered two anomia treatments, phonomotor treatment (PMT) and semantic feature analysis, modified to include a focus on reading throughout the therapy. Chronic left-hemisphere stroke survivors (N = 5) completed one or two 60-hr treatment rounds. Based on predictions from a computational reading model, three participants received the treatment recommended for their specific reading challenges (e.g., PMT for phonological deficits), while two participants had the nonrecommended treatment first, followed by the recommended model-matched treatment. Changes in reading aloud accuracy and response times (RTs) from before to after treatment were examined as a function of matching treatment to the deficit profile, type of treatment, therapy round, and word characteristics. RESULTS Participants' reading aloud accuracy improved after treatment relative to baseline with higher accuracy for high-frequency words and shorter words. After the first treatment round, participants' accuracy and RT improved, irrespective of whether treatment was matched to the deficit profile. Furthermore, participants who completed the second treatment round continued achieving accuracy gains. Following treatment, participants demonstrated enhanced reading efficiency and generalized improvements on the selected sections of the Woodcock Reading Mastery Test. CONCLUSIONS While larger studies are needed to test for the effects of matching treatment type to the deficit profile, we conclude that treatments targeting specific information-processing components can effectively improve reading. Doubling the treatment dose offers small but significant gains. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.26517319.
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Affiliation(s)
- Olga Boukrina
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
| | - Elizabeth B Madden
- School of Communication Science and Disorders, College of Communication and Information, Florida State University, Tallahassee
| | - Nicole Giordano
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
| | - Dima Karim
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
| | - Ryan Staples
- Georgetown-Howard Universities Center for Clinical and Translational Science, Georgetown University Medical Center, Washington, DC
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC
- Department of Neurology, Georgetown University Medical Center, Washington, DC
| | - William W Graves
- Department of Psychology, Rutgers, The State University of New Jersey, Newark
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Essers B, Veerbeek JM, Luft AR, Verheyden G. The feasibility of the adapted H-GRASP program for perceived and actual daily-life upper limb activity in the chronic phase post-stroke. Disabil Rehabil 2024; 46:5815-5828. [PMID: 38329448 DOI: 10.1080/09638288.2024.2313121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/18/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Assessing feasibility and initial impact of the Home-Graded Repetitive Arm Supplementary Program combined with in-home accelerometer-based feedback (AH-GRASP) on perceived and actual daily-life upper limb (UL) activity in stroke survivors during the chronic phase with good UL motor function but low perceived daily-life activity. MATERIAL AND METHODS A 4-week intervention program (4 contact hours, 48 h self-practice) encompassing task-oriented training, behavioral techniques, phone-based support, monitoring, and weekly feedback sessions using wrist-worn accelerometery was implemented using a pre-post double baseline repeated measures design. Feasibility, clinical assessments, patient-reported outcomes, and accelerometer data were investigated. RESULTS Of the 34 individuals approached, nineteen were included (recruitment rate 56%). Two dropped out, one due to increased UL pain (retention rate 89%). Seven (41%) achieved the prescribed exercise target (120 min/day, six days/week). Positive patient experiences and improvements in UL capacity, self-efficacy, and contribution of the affected UL to overall activity (p < 0.05, small to large effect sizes) were observed. Additionally, seven participants (41%) surpassed the minimal clinically important difference in perceived UL activity. CONCLUSIONS A home-based UL exercise program with accelerometer-based feedback holds promise for enhancing perceived and actual daily-life UL activity for our subgroup of chronic stroke survivors.
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Affiliation(s)
- Bea Essers
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | | | - Andreas R Luft
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology and Clinical Neuroscience Center, Neurocenter, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - Geert Verheyden
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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Ertas-Spantgar F, Müller SV, Korabova S, Gabel A, Schiering I, Pape AE, Hildebrandt H. Errorless learning and assistive technology did not improve the negative prognosis for severe dressing impairment after stroke if persisting for two weeks: A randomized controlled trial. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:939-947. [PMID: 35786077 DOI: 10.1080/23279095.2022.2090839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Following severe cerebrovascular accidents, patients are often unable to dress themselves. Little is known about the persistence and treatment of this impairment. Study 1 followed 23 patients who were (1) completely dependent on others for help with dressing (2) for two weeks continually until their discharge from the rehabilitation unit. Study 2, a randomized controlled trial of 24 patients, examined the effects of errorless learning and RehaGoal App-based dressing practice on recovery in dressing ability-impaired patients who also experienced visuospatial neglect and/or apraxia. The control and intervention groups both underwent a standard therapy in the rehab unit; the intervention group additionally received dressing training (seven sessions of 45 min). The primary outcome measure was the score on an adapted version of the Nottingham Stroke Dressing Assessment; secondary outcome measures were the Barthel Index and Functional Independence Measure. Less than one-third of the patients in Study1, showed improvement. In Study 2, the intervention produced no specific effect on patients' dressing ability. However, apraxia and neglect predicted improvement for both groups. If patients depend completely on assistance for dressing for two weeks, prospects for recovery are limited. Future studies should include additional intervention sessions and incorporate treatments for neglect or apraxia.
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Affiliation(s)
- Funda Ertas-Spantgar
- Faculty of Social Work, Ostfalia University of Applied Science, Wolfenbuttel, Germany
| | - Sandra Verena Müller
- Faculty of Social Work, Ostfalia University of Applied Science, Wolfenbuttel, Germany
| | - Sona Korabova
- Department of Geriatric, St.Bernward Krankenhaus, Hildesheim, Germany
| | - Alexander Gabel
- Faculty of Computer Science, Ostfalia University of Applied Science, Wolfenbuttel, Germany
| | - Ina Schiering
- Faculty of Computer Science, Ostfalia University of Applied Science, Wolfenbuttel, Germany
| | - Anna E Pape
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
| | - Helmut Hildebrandt
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, Carl von Ossietzky, University of Oldenburg, Oldenburg, Germany
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Thomasson M, Perez-Marcos D, Crottaz-Herbette S, Brenet F, Saj A, Bernati T, Serino A, Tadi T, Blanke O, Ronchi R. An immersive virtual reality tool for assessing left and right unilateral spatial neglect. J Neuropsychol 2024; 18:349-376. [PMID: 38225801 DOI: 10.1111/jnp.12361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 12/13/2023] [Accepted: 12/30/2023] [Indexed: 01/17/2024]
Abstract
The reported rate of the occurrence of unilateral spatial neglect (USN) is highly variable likely due to the lack of validity and low sensitivity of classical tools used to assess it. Virtual reality (VR) assessments try to overcome these limitations by proposing immersive and complex environments. Nevertheless, existing VR-based tasks are mostly focused only on near space and lack analysis of psychometric properties and/or clinical validation. The present study evaluates the clinical validity and sensitivity of a new immersive VR-based task to assess USN in the extra-personal space and examines the neuronal correlates of deficits of far space exploration. The task was administrated to two groups of patients with right (N = 28) or left (N = 11) hemispheric brain lesions, also undergoing classical paper-and-pencil assessment, as well as a group of healthy participants. Our VR-based task detected 44% of neglect cases compared to 31% by paper-and-pencil tests in the total sample. Importantly, 30% of the patients (with right or left brain lesions) with no clear sign of USN on the paper-and-pencil tests performed outside the normal range in the VR-based task. Voxel lesion-symptom mapping revealed that deficits detected in VR were associated with lesions in insular and temporal cortex, part of the neural network involved in spatial processing. These results show that our immersive VR-based task is efficient and sensitive in detecting mild to strong manifestations of USN affecting the extra-personal space, which may be undetected using standard tools.
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Affiliation(s)
- Marine Thomasson
- Laboratory for Behavioral Neurology and Imaging of Cognition, University of Geneva, Geneva, Switzerland
- Neuropsychology Unit, Neurology Department, University Hospital of Geneva, Geneva, Switzerland
- Cognitive and Experimental Neuropsychology Laboratory, University of Geneva, Geneva, Switzerland
| | | | - Sonia Crottaz-Herbette
- MindMaze SA, Lausanne, Switzerland
- Neuropsychology and Neurorehabilitation Service, Department of Clinical Neurosciences, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | | | - Arnaud Saj
- Laboratory for Behavioral Neurology and Imaging of Cognition, University of Geneva, Geneva, Switzerland
- Department of Psychology, University of Montréal, Montréal, Quebec, Canada
- CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, Quebec, Canada
- Spectre Biotech, Paris, France
| | - Thérèse Bernati
- Laboratory for Behavioral Neurology and Imaging of Cognition, University of Geneva, Geneva, Switzerland
| | - Andrea Serino
- MindMaze SA, Lausanne, Switzerland
- MySpace Lab, Department of Clinical Neurosciences, Lausanne, University of Lausanne, Lausanne, Switzerland
- Laboratory of Cognitive Neuroscience, Neuro-X Institute and Brain-Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Tej Tadi
- MindMaze SA, Lausanne, Switzerland
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Neuro-X Institute and Brain-Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Neurosurgery, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Roberta Ronchi
- Laboratory for Behavioral Neurology and Imaging of Cognition, University of Geneva, Geneva, Switzerland
- Neuropsychology Unit, Neurology Department, University Hospital of Geneva, Geneva, Switzerland
- Laboratory of Cognitive Neuroscience, Neuro-X Institute and Brain-Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
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10
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Stammler B, Lambert M, Schuster T, Flammer K, Karnath HO. Using augmented reality to assess spatial neglect: The Free Exploration Test (FET). J Int Neuropsychol Soc 2024; 30:635-642. [PMID: 39291435 DOI: 10.1017/s1355617724000274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
BACKGROUND To capture the distortion of exploratory activity typical of patients with spatial neglect, traditional diagnostic methods and new virtual reality applications use confined workspaces that limit patients' exploration behavior to a predefined area. Our aim was to overcome these limitations and enable the recording of patients' biased activity in real, unconfined space. METHODS We developed the Free Exploration Test (FET) based on augmented reality technology. Using a live stream via the back camera on a tablet, patients search for a (non-existent) virtual target in their environment, while their exploration movements are recorded for 30 s. We tested 20 neglect patients and 20 healthy participants and compared the performance of the FET with traditional neglect tests. RESULTS In contrast to controls, neglect patients exhibited a significant rightward bias in exploratory movements. The FET had a high discriminative power (area under the curve = 0.89) and correlated positively with traditional tests of spatial neglect (Letter Cancellation, Bells Test, Copying Task, Line Bisection). An optimal cut-off point of the averaged bias of exploratory activity was at 9.0° on the right; it distinguished neglect patients from controls with 85% sensitivity. DISCUSSION FET offers time-efficient (execution time: ∼3 min), easy-to-apply, and gamified assessment of free exploratory activity. It supplements traditional neglect tests, providing unrestricted recording of exploration in the real, unconfined space surrounding the patient.
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Affiliation(s)
- Britta Stammler
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | | | - Thomas Schuster
- XPACE GmbH, Pforzheim, Germany
- Pforzheim University of Applied Sciences, Pforzheim, Germany
| | | | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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11
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Morse H, Jolly AA, Browning H, Clark A, Pomeroy V, Rossit S. Aging effects on extrapersonal (far-space) attention: cancellation and line bisection performance from 179 healthy adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:605-626. [PMID: 37314105 DOI: 10.1080/13825585.2023.2223903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/07/2023] [Indexed: 06/15/2023]
Abstract
Assessment of cognitive impairments is a vital part of clinical practice. Cancellation (visual search) and line bisection are commonly used tasks to assess visuospatial attention. Despite the fact visuospatial attention is engaged in both near (within reach) and far-space (out of reach), most studies have been conducted in near-space alone. Moreover, despite their use in clinical practice, it is unclear whether cancellation and bisection tasks are related. Here, we investigated the impact of aging on cancellation and line bisection performance in far-space in a large healthy sample. We provide preliminary age-graded norms for assessing visuospatial attention in far-space calculated from a sample of 179 healthy adults, between the ages of 18-94 (mean age = 49.29). Cancellation and line bisection were presented on a large screen in far-space and completed using a wireless remote. Aging was accompanied by longer task duration for both tasks, slower search speed and poorer quality of search. However, there was no significant effect of aging on line bisection error. There was a significant correlation between the two tasks in that longer task duration in line bisection was associated with slower search speed and poorer quality of search. Overall, participants presented a leftward bias during cancellation and line bisection akin to pseudoneglect. Moreover, we found that irrespective of age, search speed was faster in males than females. We offer novel evidence that performance on cancellation and line bisection tasks are related to one another in far-space, but are also sensitive to age-related decline, and even sex differences.
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Affiliation(s)
- Helen Morse
- School of Psychology, University of East Anglia, Norwich, UK
| | - Amy A Jolly
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Hannah Browning
- School of Psychology, University of East Anglia, Norwich, UK
| | - Allan Clark
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Valerie Pomeroy
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
- NIHR Brain Injury MedTech Co-Operative, University of Cambridge, Cambridge, UK
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12
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Scheffels JF, Lipinsky C, Korabova S, Eling P, Kastrup A, Hildebrandt H. The influence of clinical characteristics on prism adaptation training in visuospatial neglect: A post-hoc analysis of a randomized controlled trial. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:678-688. [PMID: 35416101 DOI: 10.1080/23279095.2022.2061353] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Previous studies indicate that the effect of prism adaptation training (PAT) on unilateral neglect may depend on clinical characteristics. In this explorative work, we re-analyzed data from a previously conducted randomized controlled trial (N = 23) to investigate whether age, etiology, severity of motor impairments, and visual field deficits affect the efficacy of PAT. Additionally, we reviewed PAT studies that reported lesion maps and distinguished responders from non-responders. We transferred these maps into a common standard brain and added data from 12 patients from our study. We found patients suffering from subarachnoid bleeding appeared to show stronger functional recovery than those with intracranial hemorrhage or cortical infarction. Furthermore, patients with visual field deficits and those with more severe contralateral motor impairments had larger after-effect sizes but did not differ in treatment effects. In addition, patients with parietal lesions showed reduced recovery, whereas patients with lesions in the basal ganglia recovered better. We conclude that PAT (in its current form) is effective when fronto-subcortical areas are involved but it may not be the best choice when parietal regions are affected. Overall, the present work adds to the understanding on the effects of clinical characteristics on PAT.
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Affiliation(s)
- J F Scheffels
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
| | - C Lipinsky
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - S Korabova
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
| | - P Eling
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - A Kastrup
- Department of Neurology, Klinikum Bremen-Mitte, Bremen, Germany
| | - H Hildebrandt
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
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13
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Konik S, Beaud V, Fellrath J, Martinelli I, Guanziroli E, Molteni F, Bassolino M, Serino A. Evaluation of upper limb perception after stroke with the new Affected Limb Perception Questionnaire (ALPQ): a study protocol. BMC Neurol 2024; 24:196. [PMID: 38862898 PMCID: PMC11165777 DOI: 10.1186/s12883-024-03648-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/22/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Following a stroke, patients may suffer from alterations in the perception of their own body due to an acquired deficit in body representations. While such changes may impact their quality of life as well as recovery, they are not systematically assessed in clinical practice. This study aims at providing a better understanding of the rate, evolution, and impact on recovery of upper limb (UL) body perceptions (BPs) alterations following stroke. In addition, we will investigate associations among BPs alterations items, their associations with the sensorimotor functions, UL activity, damages in brain structure and connectivity. METHODS We developed a new tool named ALPQ (for Affected Limb Perception Questionnaire) to address the present study objectives. It assesses subjective alterations in the perception of the affected UL following stroke, by measuring several dimensions, namely: anosognosia for hemiplegia, anosodiaphoria for hemiplegia, hemiasomatognosia, somatoparaphrenia, personification of the affected limb, illusion of modification of physical characteristics (temperature, weight, length), illusory movements, super- or undernumerary limb, UL disconnection, misoplegia, and involuntary movement. This study combines a cross-sectional and longitudinal design. The completed data sample will include a minimum of 60 acute and 100 sub-acute stroke patients. When possible, patients are followed up to the chronic stage. Complementary evaluations are administered to assess patients' sensorimotor and cognitive functions as well as UL activity, and brain lesions will be analysed. DISCUSSION This study will provide a better understanding of BPs alterations following stroke: their rate and evolution, as well as their associations with sensorimotor deficit, cognitive profile and UL activity, brain lesions and recovery. Ultimately, the results could support the personalization of rehabilitation strategy according to patients' UL perception to maximize their recovery. STUDY REGISTRATION The protocol for this study has been pre-registered on the Open Science Framework on July the 7th, 2021: https://osf.io/p6v7f .
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Affiliation(s)
- Stéphanie Konik
- MySpace Lab, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Valérie Beaud
- Service of Neuropsychology and Neurorehabilitation, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Julia Fellrath
- MySpace Lab, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Département Hospitalier, Institution de Lavigny, Lavigny, Switzerland
| | - Isabella Martinelli
- MySpace Lab, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Villa Beretta Rehabilitation Center, Ospedale Valduce, Costa Masnaga, Italy
- School of Health Sciences, Institute of Health, HES-SO Valais-Wallis, Sion, Switzerland
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | - Franco Molteni
- Villa Beretta Rehabilitation Center, Ospedale Valduce, Costa Masnaga, Italy
| | - Michela Bassolino
- MySpace Lab, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- School of Health Sciences, Institute of Health, HES-SO Valais-Wallis, Sion, Switzerland.
- The Sense, Innovation and Research Center, Sion and Lausanne, Switzerland.
| | - Andrea Serino
- MySpace Lab, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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14
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Terruzzi S, Albini F, Massetti G, Etzi R, Gallace A, Vallar G. The Neuropsychological Assessment of Unilateral Spatial Neglect Through Computerized and Virtual Reality Tools: A Scoping Review. Neuropsychol Rev 2024; 34:363-401. [PMID: 36913099 PMCID: PMC10009867 DOI: 10.1007/s11065-023-09586-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 09/28/2022] [Indexed: 03/14/2023]
Abstract
Unilateral Spatial Neglect is a disabling neuropsychological deficit. Patients with spatial neglect fail to detect and report events, and to perform actions in the side of space contralateral to a hemispheric cerebral lesion. Neglect is assessed by evaluating the patients' abilities in daily life activities and by psychometric tests. Computer-based, portable and Virtual Reality technologies may provide more and precise data, and be more sensitive and informative, compared to current paper-and-pencil procedures. Studies since 2010, in which such technologies have been used, are reviewed. Forty-two articles meeting inclusion criteria are categorized according to their technological approaches (computer-, graphics tablet or tablet-, virtual reality-based assessment, and other). The results are promising. However, a definite golden standard, technologically based procedure cannot be still established. Developing technologically based tests is a laborious process, which requires technical and user experience improvements as well as normative data, to increase the evidence of efficacy for clinical evaluation of at least some of the tests considered in this review.
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Affiliation(s)
- Stefano Terruzzi
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy.
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy.
- Neurocognitive Rehabilitation Center (CeRiN), University of Trento, Rovereto, Italy.
| | - Federica Albini
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Gemma Massetti
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Roberta Etzi
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Alberto Gallace
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Vallar
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy.
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy.
- Neuropsychological Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Auxologico Italiano, Milan, Italy.
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15
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Minga J, Rich T, Boukrina O, Chen P, Hreha K. Identifying Spatial Neglect in Chronic Right Hemisphere Stroke Survivors Using the RHDBank Outcomes. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:511-523. [PMID: 38181442 PMCID: PMC11000791 DOI: 10.1044/2023_jslhr-23-00285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/23/2023] [Accepted: 10/19/2023] [Indexed: 01/07/2024]
Abstract
PURPOSE The chronicity of spatial neglect (SN) and the utility of existing diagnostic measures used by speech-language pathologists remain poorly understood. In this retrospective study, we examined how the RHDBank test battery informs the identification of SN after right hemisphere brain damage (RHD) during the chronic phase of recovery. METHOD Data from 29 right hemisphere stroke survivors were extracted from the RHDBank, including SN tests, for which we performed laterality index scoring: a 51-item demographic survey, the Apples Test, the Indented Paragraph Test, and the clock drawing task from the Cognitive Linguistic Quick Test (CLQT). Two groups (SN+ and SN-) were identified using the Apples Test. A hierarchical cluster analysis explored CLQT performance clusters in association with SN, and group comparisons of demographic variables and test scores were conducted. RESULTS Ten patients were identified as having SN+ (34%) using the Apples Test. The Indented Paragraph Test and the CLQT's clock drawing test identified only two of the 20 stroke survivors with SN+. Cluster analyses showed that domain and task scores on the CLQT carried information to classify participants into SN+ and SN- in concordance with performance on the Apples Test. Participants in the SN+ cluster had moderately impaired attention and executive function skills and mildly impaired visuospatial skills. CONCLUSIONS The Apples Test differentiated SN in a group of chronic right hemisphere stroke survivors. Using multiple measures from the CLQT seemed to capture a greater range of problems than clock drawing and paragraph reading tests alone. Therefore, the RHDBank test battery as a whole-and in part the CLQT, Apples Test, and Indented Paragraph Test-can detect certain subtypes of SN in the chronic deficit profile after RHD and is a starting point for diagnostic integration by speech-language pathologists.
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Affiliation(s)
- Jamila Minga
- Department of Head and Neck Surgery & Communication Sciences and Department of Neurology, Duke University, Durham, NC
| | - Timothy Rich
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
| | - Olga Boukrina
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
| | - Peii Chen
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ
| | - Kimberly Hreha
- Occupational Therapy Doctorate Division, Department of Orthopaedic Surgery, Duke University, Durham, NC
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16
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Moore MJ, Hearne L, Demeyere N, Mattingley JB. Comprehensive voxel-wise, tract-based, and network lesion mapping reveals unique architectures of right and left visuospatial neglect. Brain Struct Funct 2023; 228:2067-2087. [PMID: 37697138 PMCID: PMC10587018 DOI: 10.1007/s00429-023-02702-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/27/2023] [Indexed: 09/13/2023]
Abstract
Visuospatial neglect is a common, post-stroke cognitive impairment which is widely considered to be a disconnection syndrome. However, the patterns of disconnectivity associated with visuospatial neglect remain unclear. Here, we had 480 acute stroke survivors [age = 72.8 (SD = 13.3), 44.3% female, 7.5 days post-stroke (SD = 11.3)] undertake routine clinical imaging and standardised visuospatial neglect testing. The data were used to conduct voxel-wise, tract-level, and network-level lesion-mapping analyses aimed at localising the neural correlates of left and right egocentric (body-centred) and allocentric (object-centred) visuospatial neglect. Only minimal anatomical homogeneity was present between the correlates of right and left egocentric neglect across all analysis types. This finding challenges previous work suggesting that right and left visuospatial neglect are anatomically homologous, and instead suggests that egocentric neglect may involve damage to a shared, but hemispherically asymmetric attention network. By contrast, egocentric and allocentric neglect was associated with disconnectivity in a distinct but overlapping set of network edges, with both deficits related to damage across the dorsal and ventral attention networks. Critically, this finding suggests that the distinction between egocentric and allocentric neglect is unlikely to reflect a simple dichotomy between dorsal versus ventral networks dysfunction, as is commonly asserted. Taken together, the current findings provide a fresh perspective on the neural circuitry involved in regulating visuospatial attention, and provide important clues to understanding the cognitive and perceptual processes involved in this common and debilitating neuropsychological syndrome.
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Affiliation(s)
- Margaret Jane Moore
- Queensland Brain Institute, University of Queensland, St. Lucia, QLD, 4072, Australia.
| | - Luke Hearne
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Jason B Mattingley
- Queensland Brain Institute, University of Queensland, St. Lucia, QLD, 4072, Australia
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17
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Schenke N, Eling P, Duning T, Hildebrandt H. Monocular eye patching modulates ipsilesional reactive saccades and smooth pursuit in patients with left hemispatial neglect. Brain Cogn 2023; 173:106101. [PMID: 39492218 DOI: 10.1016/j.bandc.2023.106101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/11/2023] [Accepted: 10/14/2023] [Indexed: 11/05/2024]
Abstract
Patients with hemispatial neglect show multiple oculomotor deficits like delayed contralesional saccade latencies, hypometric saccade amplitudes, and impaired smooth pursuit. We aimed to investigate whether modulation of superior colliculus (SC) activity via monocular eye patching improves neglect patients' eye movements to the contralesional side of space. Thirteen neglect patients with left-hemispheric (LH) stroke, 22 neglect patients with right-hemispheric (RH) stroke, and 24 healthy controls completed a video-oculographic examination of horizontal smooth pursuit and reactive saccades twice, while the left or right eye was covered with an eye patch. Independent of the eye patch position, LH and RH patients showed enlarged saccade latencies toward contralesional stimuli. In addition, both during smooth pursuit and reactive saccades, RH patients made significantly fewer rightward saccades when the right than when the left eye was patched. Moreover, during reactive saccades, RH patients made significantly fewer right than left saccades, but only when the right eye was patched. These findings suggest that the ipsilesional eye patch modulated ipsilesional ocular performance in the RH group, presumably resulting from differences in SC activity. Yet, ipsilesional eye patching did not improve eye movements to the contralesional side of space, possibly due to the incomplete contralateral retinocollicular projection in humans.
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Affiliation(s)
- Nadine Schenke
- Clinic for Neurology, Klinikum Bremen-Ost, Bremen, Germany; Department of Psychology, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.
| | - Paul Eling
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Thomas Duning
- Clinic for Neurology, Klinikum Bremen-Ost, Bremen, Germany
| | - Helmut Hildebrandt
- Clinic for Neurology, Klinikum Bremen-Ost, Bremen, Germany; Department of Psychology, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
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18
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Kis A, Radics E, Bolló H, Topál J. Methodological comparison of cancellation versus two-way choice spatial attention tests in humans and dogs. Front Vet Sci 2023; 10:1264151. [PMID: 37901109 PMCID: PMC10603243 DOI: 10.3389/fvets.2023.1264151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/27/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Behavioural problems in family dogs are amongst the leading reasons for relinquishment to shelters which adversely affects animal welfare. Recent research suggests that certain problematic behavioural patterns might be analogous to human psychiatric disorders. Veterinary diagnosis of such conditions, however, is scarce, probably due to the lack of appropriate measurement tools. The current study focuses on dog behaviour resembling the human hemispatial neglect condition, which manifests itself as a deficit in attention to and awareness of one side of the space. Methods Healthy human subjects (N = 21) and adult family dogs (N = 23) were tested with tools aimed to measure spatial attention. Tests administered to humans included validated paper and pencil neuropsychological tools to assess hemispatial neglect (cancellation tasks), as well as the canine version of that task (visuo-spatial search task). Dogs were tested with the same visuo-spatial search task as well as a two-way choice task. Results Results show that both in case of dogs and humans the visuo-spatial search task detects individual variation in subjects' side preferences. However, subjects' performance in the different tasks were not related.
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Affiliation(s)
- Anna Kis
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
- ELTE-HUNREN NAP Comparative Ethology Research Group, Budapest, Hungary
| | - Eszter Radics
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Henrietta Bolló
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - József Topál
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
- ELTE-HUNREN NAP Comparative Ethology Research Group, Budapest, Hungary
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19
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Jang WH, Jang JS. Standardization of apple cancellation test for neglect patients in Korea: An observational study. World J Clin Cases 2023; 11:5236-5243. [PMID: 37621587 PMCID: PMC10445065 DOI: 10.12998/wjcc.v11.i22.5236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/08/2023] [Accepted: 07/11/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Neglect can be divided into two types using apple cancellation test (apple test): Egocentric neglect (EN) and allocentric neglect (AN). However, in South Korea, apple test results and decision criteria are still largely dependent on tests by foreign countries. AIM To establish a new South Korea standard and improve the accuracy of neglect assessment, the apple experiment was standardized in this study. METHODS This study was conducted on 223 healthy subjects for a total of 7 mo from August 2021 to February 2022. Standardization was carried out using the original apple test developed by Bickerton in 2011. In scoring for the apple test, total omission error refers to the number of missed targets (full apple) in the entire test sheet (left, middle, and right area). The score for EN is the difference between the cor-rect number of right area and the correct number of left area (excluding the middle area). For AN, the score is difference between the number of left opening apples and number of right opening apples (including the middle area). Linear regression analysis was used for standardization using the general characteristics of subjects and the results of the apple test. RESULTS The cut-off score, which is the standard value indicating the pathological condition by combining the results of all subjects, is as follows: Total omission error (5), error for EN (2), and error for AN (2). Also, differences in cut-off score according to age were found. CONCLUSION This study will be helpful in facilitating a more accurate differential diagnosis of neglect.
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Affiliation(s)
- Woo-Hyuk Jang
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Samcheok-si 25949, Gangwon-do, South Korea
| | - Jong-Sik Jang
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Samcheok-si 25949, Gangwon-do, South Korea
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20
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Jang WH, Jang JS. Standardization of apple cancellation test for neglect patients in Korea: An observational study. World J Clin Cases 2023; 11:5230-5237. [DOI: 10.12998/wjcc.v11.i22.5230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/08/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Neglect can be divided into two types using apple cancellation test (apple test): Egocentric neglect (EN) and allocentric neglect (AN). However, in South Korea, apple test results and decision criteria are still largely dependent on tests by foreign countries.
AIM To establish a new South Korea standard and improve the accuracy of neglect assessment, the apple experiment was standardized in this study.
METHODS This study was conducted on 223 healthy subjects for a total of 7 mo from August 2021 to February 2022. Standardization was carried out using the original apple test developed by Bickerton in 2011. In scoring for the apple test, total omission error refers to the number of missed targets (full apple) in the entire test sheet (left, middle, and right area). The score for EN is the difference between the cor-rect number of right area and the correct number of left area (excluding the middle area). For AN, the score is difference between the number of left opening apples and number of right opening apples (including the middle area). Linear regression analysis was used for standardization using the general characteristics of subjects and the results of the apple test.
RESULTS The cut-off score, which is the standard value indicating the pathological condition by combining the results of all subjects, is as follows: Total omission error (5), error for EN (2), and error for AN (2). Also, differences in cut-off score according to age were found.
CONCLUSION This study will be helpful in facilitating a more accurate differential diagnosis of neglect.
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Affiliation(s)
- Woo-Hyuk Jang
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Samcheok-si 25949, Gangwon-do, South Korea
| | - Jong-Sik Jang
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Samcheok-si 25949, Gangwon-do, South Korea
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21
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Jang WH, Seo SM. Digital Therapeutics for the Egocentric and Allocentric Neglects in Patients with Brain Injury: A Mini Review. Brain Sci 2023; 13:1170. [PMID: 37626526 PMCID: PMC10452466 DOI: 10.3390/brainsci13081170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/28/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Various therapeutic approaches have been developed for neglect. Many studies have demonstrated the effect of digital therapeutics (DTx) on neglect. However, few studies have reported the effects of DTx on egocentric and allocentric neglect. The differentiation of types of neglect and separate interventions is crucial in the rehabilitation process. In this article, seven studies on DTx on egocentric and allocentric neglect were reviewed. DTx, which was employed in these studies, could be classified as follows: (1) software adaptation in traditional treatment, (2) VR game using the head-mount display as treatment, and (3) the development of a new digital program like ReMoVES. In addition, more studies and more effective results were reported for egocentric neglect than for allocentric neglect. In future studies, each effect on egocentric and allocentric neglect should be identified in detail with the appropriate use of differential evaluation and long-term application of independent DTx.
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Affiliation(s)
- Woo-Hyuk Jang
- Department of Occupational Therapy, Kangwon National University, Samcheok 25949, Republic of Korea;
| | - Sang-Min Seo
- Department of Occupational Therapy, Semyung University, Jecheon 27136, Republic of Korea
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22
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Martin J, Vuilleumier P, Assal F, Ronchi R. Neglecting the bottom space: an object-based disorder? A two-case observational study. Neurocase 2023; 29:121-131. [PMID: 38406985 DOI: 10.1080/13554794.2024.2315860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024]
Abstract
Altitudinal neglect is an atypical form of spatial neglect where brain-damaged patients neglect the lower, or sometimes the upper, part of the space. Our understanding of this phenomena is limited, with unknown occurrence across different reference frames, such as distance (peripersonal vs. extrapersonal) and system of reference (egocentric vs. allocentric). Two patients with acute bilateral (P1) or right hemispheric (P2) stroke, with signs of bottom altitudinal neglect, underwent an extensive evaluation of neglect within 10 days post-stroke. Assessments involved altitudinal neglect and unilateral spatial neglect (USN) in peripersonal space, exploring egocentric and allocentric signs and in extrapersonal space. Compared to a control group of 15 healthy age-matched subjects, patients showed allocentric and egocentric left USN in peripersonal space, and mostly allocentric signs of altitudinal neglect. No signs of neglect were evidenced in extrapersonal space. Altitudinal neglect could thus present as an allocentric form of spatial neglect, suggesting that allocentric representations may not only affect the deployment of attentional resources along horizontal dimensions but also operate along vertical dimensions. Future studies should deepen our understanding of altitudinal neglect, eventually leading to further unravel spatial processes that control attention, their corresponding brain mechanisms, and implications for patients' rehabilitation and functional outcome.
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Affiliation(s)
- Jennifer Martin
- Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Patrik Vuilleumier
- Laboratory of Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
- Faculty of Medecine, University of Geneva, Geneva, Switzerland
| | - Frédéric Assal
- Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medecine, University of Geneva, Geneva, Switzerland
| | - Roberta Ronchi
- Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland
- Laboratory of Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
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23
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Schenke N, Diestel E, Kastrup A, Eling P, Hildebrandt H. Monocular eye patching modulates reorienting of covert attention in patients with unilateral middle cerebral artery stroke. Brain Cogn 2023; 169:106000. [PMID: 37253302 DOI: 10.1016/j.bandc.2023.106000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/01/2023]
Abstract
Unilateral brain lesions can lead to impaired contralesional attention and reduced ipsilesional and enhanced contralesional superior colliculus (SC) activity. We aimed to investigate whether modulation of SC activation via monocular eye patching can improve contralesional attention. Twenty left-hemispheric (LH) and 20 right-hemispheric (RH) patients with an acute or subacute middle cerebral artery (MCA) stroke completed an endogenous version of the Posner cueing task twice, while the left or right eye was covered with an eye patch. The LH and RH patients showed significantly slower reactions to contralesional than to ipsilesional stimuli. In addition, the eye patch modulated responses to invalidly but not those to validly cued stimuli. Post hoc analyses could not discriminate whether this effect pertained to a particular target side or eye patch position. However, exploratory analyses indicated that the observed eye patch effect might affect the RH group more than the LH group. As predicted 36 years ago, monocular eye patching modulates visuospatial attention, presumably due to differences in SC activation between the two eye patch conditions. However, this modulation seems too weak and unspecific, and therefore possibly not strong enough to be a treatment option for patients with visuospatial attention impairments.
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Affiliation(s)
- Nadine Schenke
- Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany; Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany.
| | - Elfriede Diestel
- Department for Education and Human Development, Leibniz Institute for Research and Information in Education, Frankfurt/Main, Germany
| | - Andreas Kastrup
- Department of Neurology, Klinikum Bremen-Mitte, Bremen, Germany
| | - Paul Eling
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, the Netherlands
| | - Helmut Hildebrandt
- Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany; Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
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Jang WH, Hwang HM, Kim JY. Effects of Twins Therapy on Egocentric and Allocentric Neglect in Stroke Patients: A Feasibility Study. Brain Sci 2023; 13:952. [PMID: 37371430 DOI: 10.3390/brainsci13060952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/06/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: Existing treatment methods for neglect are concentrated on egocentric neglect and may lead to various problems such as cost/space constraints and portability. Therefore, this study seeks to determine how a new treatment (also known as twins therapy, TT) for stroke patients can improve an existing problem associated with neglect. (2) Method: A pre/post-test control group research design was used and both groups continued to receive existing rehabilitation treatment, whilst TT intervention was only added to the experimental group. TT intervention was conducted for a total of 20 sessions (1 session for 30 min/day, 5 days/week, for 4 weeks). (3) Result: There was no significant difference in the manual function test (MFT) and the Korean version of the Modified Barthel Index (K-MBI) items (p > 0.05) before and after the TT intervention. However, the score and execution time of the apple cancellation test showed a significant reduction only in the experimental group (p < 0.05). (4) Conclusion: TT not only improved egocentric neglect, but also allocentric neglect symptoms in stroke patients.
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Affiliation(s)
- Woo-Hyuk Jang
- Department of Occupational Therapy, Kangwon National University, Samcheok 25949, Republic of Korea
| | - Hyeong-Min Hwang
- Department of Occupational Therapy, Kangwon National University, Samcheok 25949, Republic of Korea
| | - Jae-Yeop Kim
- Department of Occupational Therapy, Kangwon National University, Samcheok 25949, Republic of Korea
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25
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De Luca M, Baroncini M, Matano A, Di Lorenzo C, Magnotti L, Lucatello S, Mulas M, Pollarini V, Ciurli MP, Nardo D. Sensitivity and Specificity of the Brentano Illusion Test in the Detection of Visual Hemi-Field Deficits in Patients with Unilateral Spatial Neglect. Brain Sci 2023; 13:937. [PMID: 37371415 DOI: 10.3390/brainsci13060937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Stroke survivors with right-brain damage (RBD) often present with attentional deficits such as left unilateral spatial neglect. Some patients also present with contralesional visual hemi-field deficits. A late detection of visual hemi-field deficits (VHFD) contributes to hampering neurorehabilitation and functional outcome of patients with neglect. The Brentano Illusion Test (BRIT) may be used for an early detection of VHFD during the neuropsychological assessment. In the present study, we determined the sensitivity and specificity of the BRIT for screening VHFD in patients with neglect. Sixty-four consecutive RBD patients were examined. Forty-five presented with neglect. Of these, 23 presented with VHFD (hemianopia or quadrantanopia) as detected by the Humphrey automated static visual field testing (reference standard). Consecutive patients also included 19 participants without neglect, who did not have any VHFD. The sensitivity and specificity of the BRIT for neglect patients were 78.3% (95% CI: 61.4-95.1) and 90.9 (95% CI: 78.9-100.0), respectively. Positive predictive value (PPV) was 89.6% (95% CI: 76.4-100.0); negative predictive value (NPV) 80.7% (95% CI: 65.2-96.2). No false positives in the group without neglect were identified. We conclude that the BRIT is an effective tool for clinical neuropsychologists to screen for possible VHFD in neglect patients during the neuropsychological assessment, allowing the refinement of the clinical picture in the neuropsychological report. An early detection of VHFD also allows referring the patient to standard diagnostics for a formal visual field examination, right from the first neuropsychological assessment.
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Affiliation(s)
| | | | | | | | | | | | - Martina Mulas
- Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Virginia Pollarini
- Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Davide Nardo
- Department of Education, University of Roma Tre, 00185 Rome, Italy
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26
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Massetti G, Albini F, Casati C, Toneatto C, Terruzzi S, Etzi R, Tesio L, Gallace A, Vallar G. Validation of "Neurit.Space": Three Digital Tests for the Neuropsychological Evaluation of Unilateral Spatial Neglect. J Clin Med 2023; 12:jcm12083042. [PMID: 37109378 PMCID: PMC10143133 DOI: 10.3390/jcm12083042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Patients suffering from Unilateral Spatial Neglect (USN) fail to pay attention to, respond to, and report sensory events occurring in the contralesional side of space. The traditional neuropsychological assessment of USN is based on paper-and-pencil tests, whose data recording and scoring may be subjected to human error. The utilization of technological devices can be expected to improve the assessment of USN. Therefore, we built Neurit.Space, a modified digital version of three paper-and-pencil tests, widely used to detect signs of USN, namely: Bells Cancellation, Line Bisection and Five Elements Drawing Test. Administration and data processing is fully automatic. Twelve right brain-damaged patients (six with and six without USN) and 12 age- and education-balanced healthy participants were enrolled in the study. All participants were administered both the computerized and the paper-and-pencil versions of the tests. The results of this preliminary study showed good sensitivity, specificity, and usability of Neurit.Space, suggesting that these digital tests are a promising tool for the evaluation of USN, both in clinical and in research settings.
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Affiliation(s)
- Gemma Massetti
- Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
- NeuroMI-Milan Center for Neuroscience, University of Milano-Bicocca, 20126 Milan, Italy
- MiBTec-Mind and Behavior Technological Center, University of Milano-Bicocca, 20126 Milan, Italy
- Specialistic Rehabilitation Unit, Neuropsychological Service, Casa di Cura Villa Barbarano, 25128 Brescia, Italy
| | - Federica Albini
- NeuroMI-Milan Center for Neuroscience, University of Milano-Bicocca, 20126 Milan, Italy
- MiBTec-Mind and Behavior Technological Center, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
- Neuropsychological Service, Department of Neurology, Desio Hospital, ASST Brianza, 20900 Monza, Italy
| | - Carlotta Casati
- Neuropsychological Laboratory, Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, 20122 Milan, Italy
| | - Carlo Toneatto
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Stefano Terruzzi
- MiBTec-Mind and Behavior Technological Center, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Roberta Etzi
- NeuroMI-Milan Center for Neuroscience, University of Milano-Bicocca, 20126 Milan, Italy
- MiBTec-Mind and Behavior Technological Center, University of Milano-Bicocca, 20126 Milan, Italy
| | - Luigi Tesio
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, 20122 Milan, Italy
- Department of Biomedical Sciences for Healthy, University of Milan, 20122 Milan, Italy
| | - Alberto Gallace
- NeuroMI-Milan Center for Neuroscience, University of Milano-Bicocca, 20126 Milan, Italy
- MiBTec-Mind and Behavior Technological Center, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Giuseppe Vallar
- NeuroMI-Milan Center for Neuroscience, University of Milano-Bicocca, 20126 Milan, Italy
- MiBTec-Mind and Behavior Technological Center, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
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27
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Chen H, Yu S, Pan X, Chen Y, Zhang T, Li Z, Zhou J, Hu J, Bickerton WL, Lau JK, Guo A, Kong APH, Rotshtein P. The Cognitive Makeup of Writing: Multivariate Analysis of Writing Impairments Following Stroke. Cognit Comput 2023. [DOI: 10.1007/s12559-023-10111-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
AbstractWriting is a recently acquired skill to human behavioral repertoire, essential in industrialized societies. In the clinic, writing impairment is evident in one-third of stroke patients. This study aimed to find out the cognitive features that contribute to writing impairment of stroke patients in two different writing systems (logographic and phonological). Cognitive profiles were assessed using the Birmingham Cognitive Screen in two cohorts, China (244 patients) and UK (501 patients). The datasets were analyzed separately using an identical procedure. Elastic net was used to rank the importance of different cognitive abilities (features) to writing skill; and linear support vector machine was used to identify the discriminative features needed to accurately identify the stroke patients with and without writing impairments. The prediction performance was evaluated with the area under the curve (AUC), accuracy (ACC), sensitivity (SEN), and specificity (SPE). For the China cohort, writing numbers, complex figure copy, and number calculation obtained good prediction performance on writing impairments with AUC 0.85 ± 0.06, ACC (89 ± 3) %, SEN (81 ± 10) %, and SPE (90 ± 27) %. Concerning the UK data, writing numbers, number calculation, non-word reading, and auditory sustain attention achieved AUC 0.79 ± 0.04, ACC (83 ± 3) %, SEN (74 ± 9) %, and SPE (84 ± 3) %. A small number of patients in both cohorts (China: 9/69, UK: 24/137), who were impaired in writing, were consistently misclassified. Two patients, one in each cohort, showed selective impairments in writing, while all remaining patients were impaired in attention, language, and/or praxis tasks. The results showed that the capability to write numbers and manipulate them were critical features for predicting writing abilities across writing systems. Reading abilities were not a good predictor of writing impairments across both cohorts. Constructive praxis (measured by complex figure copy) was relevant to impairment classification in characters-based writing (China), while phonological abilities (measured by non-word reading) were important features for impairment prediction in alphabetic writing (UK). A small proportion minority of cases with writing deficits were related to different impairment profiles. The findings in this study highlight the multifaceted nature of writing deficits and the potential use of computation methods for revealing hidden cognitive structures in neuropsychological research.
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28
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Moore MJ, Driscoll R, Colwell M, Hewitt O, Demeyere N. Aligning formal and functional assessments of Visuospatial Neglect: A mixed-methods study. Neuropsychol Rehabil 2022; 32:2560-2579. [PMID: 34392812 DOI: 10.1080/09602011.2021.1967172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
ABSTRACTThe occurrence of visuospatial neglect acts as a key predictor of recovery outcome following stroke. However, the specific behavioural profiles associated with various neglect subtypes are not well understood. This study aims to identify real-world functional impairments associated with neglect, to determine whether functional impairment profiles differ across patients with egocentric and allocentric neglect, and to investigate how neglect severity predicts functional impairments.Notes from 290 stroke patients' occupational therapy functional assessments were qualitatively and quantitatively analysed in the context of neglect type and severity as reported by the OCS Cancellation Task. Overall, neglect patients had more references to having difficulty initiating tasks, finding items, exhibiting spatial inattention, and having difficulty using both arms than patients without neglect. The proportion of theme references did not differ significantly across patients with egocentric and allocentric neglect. The quantitative severity of egocentric neglect was acted as a significant predictor of reference occurrence over and above stroke severity within difficulty finding items, spatial inattention, body inattention, and upper limb use.This study expands on previous findings by identifying real-world functional impairments differentiating patients with and without neglect. This data provides novel insight into the impact of neglect on functional abilities.
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Affiliation(s)
- Margaret Jane Moore
- Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
| | - Rebecca Driscoll
- Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
| | - Michael Colwell
- Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
| | - Olivia Hewitt
- Oxford Institute of Clinical Psychology Training and Research, Isis Education Centre, Warneford Hospital, Oxford, UK
| | - Nele Demeyere
- Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
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29
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González-Rodriguez B, Serradell-Ribé N, Viejo-Sobera R, Romero-Muñoz JP, Marron EM. Transcranial direct current stimulation in neglect rehabilitation after stroke: a systematic review. J Neurol 2022; 269:6310-6329. [PMID: 36138161 PMCID: PMC9618519 DOI: 10.1007/s00415-022-11338-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/22/2022]
Abstract
Hemispatial neglect is one of the most frequent attention disorders after stroke. The presence of neglect is associated with longer hospital stays, extended rehabilitation periods, and poorer functional recovery. Transcranial direct current stimulation (tDCS) is a new technique with promising results in neglect rehabilitation; therefore, the objective of this systematic review, performed following the PRISMA guidelines, is to evaluate the effectiveness of tDCS on neglect recovery after stroke. The search was done in MEDLINE (PubMed), Web of Science, Scopus, Cochrane Library, and BioMed Central databases. A total of 311 articles were found; only 11 met the inclusion criteria, including 152 post-stroke patients in total. Methodological quality and risk of bias were assessed for all the studies, and methodological characteristics of the studies, sample sizes, methods, main results, and other relevant data were extracted. tDCS intervention ranged from one to twenty sessions distributed in 1 day to 4 weeks, with intensity ranged from 1 to 2 mA. We found moderate evidence for the efficacy of tDCS in the rehabilitation of hemispatial neglect after a stroke, being more effective in combination with other interventions. Nonetheless, the limited number of studies and some studies' design characteristics makes it risky to draw categorical conclusions. Since scientific evidence is still scarce, further research is needed to determine the advantage of this treatment in acute, sub-acute and chronic stroke patients. Future studies should include larger samples, longer follow-ups, and broader neurophysiological assessments, with the final aim of establishing the appropriate use of tDCS as an adjuvant intervention in neurorehabilitation settings.
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Affiliation(s)
- B González-Rodriguez
- Brain Damage Unit, Beata María Ana Hospital, Madrid, Spain.,Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - N Serradell-Ribé
- Faculty of Health Sciences, Cognitive NeuroLab, Universitat Oberta de Catalunya, Madrid, Barcelona, Spain
| | - R Viejo-Sobera
- Faculty of Health Sciences, Cognitive NeuroLab, Universitat Oberta de Catalunya, Madrid, Barcelona, Spain
| | - J P Romero-Muñoz
- Brain Damage Unit, Beata María Ana Hospital, Madrid, Spain.,Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Elena M Marron
- Faculty of Health Sciences, Cognitive NeuroLab, Universitat Oberta de Catalunya, Madrid, Barcelona, Spain.
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30
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Minga J, Stockbridge MD, Durfee A, Johnson M. Clinical Guidelines for Eliciting Discourse Using the RHDBank Protocol. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1949-1962. [PMID: 36044890 PMCID: PMC9907450 DOI: 10.1044/2022_ajslp-22-00097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/12/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Examining discourse after right hemisphere brain damage (RHD) can provide invaluable clinical data and insight into functional communication capabilities. Yet, clinicians preparing to enter the field may have limited experience eliciting and analyzing discourse for therapeutic purposes. The purpose of this work is to present a practical guide for the clinical use of the RHDBank protocol. METHOD Following a brief overview of the RHDBank protocol, elicitation guidelines and protocol administration considerations are offered. Measures that should be considered when analyzing RHDBank-elicited discourse are summarized. The RHDBank protocol is positioned as an accessible resource for discourse elicitation in the clinical setting, and examples for the clinical use of the protocol are provided. CONCLUSIONS Discourse production can be a key source of information regarding communication ability following RHD. The RHDBank provides a structured and scripted approach to the clinical elicitation of language and consideration of discourse production. Its immediate clinical utility will assist developing clinicians with the acquisition of a clinically relevant elicitation approach and more comprehensive view of the RHD communication impairments. Application of the protocol can aid in collective knowledge advancement that will promote a better understanding of RHD language production as a clinical entity with an array of possible characteristics.
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Affiliation(s)
- Jamila Minga
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
| | - Melissa D. Stockbridge
- Department of Neurology, Cerebrovascular Division, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alexandra Durfee
- Department of Neurology, Cerebrovascular Division, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Melissa Johnson
- Department of Communication Sciences and Disorders, Nazareth College, Rochester, NY
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31
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Lee SH, Lim BC, Jeong CY, Kim JH, Jang WH. Assessment tools for differential diagnosis of neglect: Focusing on egocentric neglect and allocentric neglect. World J Clin Cases 2022; 10:8625-8633. [PMID: 36157805 PMCID: PMC9453377 DOI: 10.12998/wjcc.v10.i24.8625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/09/2022] [Accepted: 07/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND There are very few studies on the differential diagnosis between egocentric neglect (EN) and allocentric neglect (AN).
AIM To investigate the overall trend of the previously developed assessment tools by conducting a descriptive review of the studies on assessment tools that can perform a differential diagnosis of EN and AN.
METHODS The data were collected by using databases such as Google Scholar, PubMed, and ScienceDirect. The most commonly used search terms were “neglect”, “stroke”, “egocentric neglect”, and “allocentric neglect”.
RESULTS A total of seven studies that met the inclusion criteria were selected and analyzed. We were able to confirm the research process, test method, and differential diagnosis criteria of the seven presented assessment tools from four studies on paper-based tests and three studies on computerized tests. The majority of the tests were carried out via the cancellation method using stimuli such as everyday objects or numbers. EN distinguished the left from right based on the test paper, while AN distinguished the left from right based on stimuli. In order to perform differential diagnosis, the difference in the number of left and right responses or non-responses was used based on the EN and AN criteria.
CONCLUSION It was confirmed that all the seven assessment tools can effectively perform differential diagnosis of EN and AN. This study may provide important data that can be used in clinical practice for differential diagnosis and future intervention planning for neglect patients.
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Affiliation(s)
- Sang-Hyeok Lee
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Gangwon-do 25949, South Korea
| | - Byeong-Chan Lim
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Gangwon-do 25949, South Korea
| | - Chan-Young Jeong
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Gangwon-do 25949, South Korea
| | - Jun-Hyeok Kim
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Gangwon-do 25949, South Korea
| | - Woo-Hyuk Jang
- Department of Occupational Therapy, College of Health Science, Kangwon National University, Gangwon-do 25949, South Korea
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32
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Reaction time analysis in patients with mild left unilateral spatial neglect employing the modified Posner task: vertical and horizontal dimensions. Exp Brain Res 2022; 240:2143-2153. [PMID: 35768734 DOI: 10.1007/s00221-022-06400-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/11/2022] [Indexed: 11/04/2022]
Abstract
Unilateral spatial neglect (USN) is a common neurological syndrome that develops after a right hemisphere lesion. By examining the performance of the modified Posner task added to the vertical dimensions of the left and right visual fields, we studied whether the lower left area had different neglect symptoms than the other locations. 41 patients with right hemisphere damage were classified into those with mild USN (USN+ ; n = 20) and without USN (USN- ; n = 21). Twenty older participants made up the healthy control (HC; n = 20) group. All participants recorded deficits in the paper-and-pencil tests established for neglect and reaction times in the modified Posner task. In the paper-and-pencil tests, there was no difference in deficit between the upper and lower left visual fields in any of the groups. According to the modified Posner task, the USN+ group exhibited delays in reaction time in the lower left visual field rather than the upper left visual field. Importantly, reaction times were delayed, and USN symptoms persisted, particularly for the lower left quadrant. Our findings imply that the modified Posner task can accurately uncover neglect symptoms in the case of mild USN.
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33
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Cavedoni S, Cipresso P, Mancuso V, Bruni F, Pedroli E. Virtual reality for the assessment and rehabilitation of neglect: where are we now? A 6-year review update. VIRTUAL REALITY 2022; 26:1663-1704. [PMID: 35669614 PMCID: PMC9148943 DOI: 10.1007/s10055-022-00648-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/24/2022] [Indexed: 06/13/2023]
Abstract
Unilateral spatial neglect (USN) is a frequent repercussion of a cerebrovascular accident, typically a stroke. USN patients fail to orient their attention to the contralesional side to detect auditory, visual, and somatosensory stimuli, as well as to collect and purposely use this information. Traditional methods for USN assessment and rehabilitation include paper-and-pencil procedures, which address cognitive functions as isolated from other aspects of patients' functioning within a real-life context. This might compromise the ecological validity of these procedures and limit their generalizability; moreover, USN evaluation and treatment currently lacks a gold standard. The field of technology has provided several promising tools that have been integrated within the clinical practice; over the years, a "first wave" has promoted computerized methods, which cannot provide an ecological and realistic environment and tasks. Thus, a "second wave" has fostered the implementation of virtual reality (VR) devices that, with different degrees of immersiveness, induce a sense of presence and allow patients to actively interact within the life-like setting. The present paper provides an updated, comprehensive picture of VR devices in the assessment and rehabilitation of USN, building on the review of Pedroli et al. (2015). The present paper analyzes the methodological and technological aspects of the studies selected, considering the issue of usability and ecological validity of virtual environments and tasks. Despite the technological advancement, the studies in this field lack methodological rigor as well as a proper evaluation of VR usability and should improve the ecological validity of VR-based assessment and rehabilitation of USN.
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Affiliation(s)
- S. Cavedoni
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - P. Cipresso
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, TO Italy
| | - V. Mancuso
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - F. Bruni
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - E. Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, eCampus University, Novedrate, Italy
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34
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Moore M, Milosevich E, Beisteiner R, Bowen A, Checketts M, Demeyere N, Fordell H, Godefroy O, Laczó J, Rich T, Williams L, Woodward-Nutt K, Husain M. Rapid screening for neglect following stroke: A systematic search and European Academy of Neurology recommendations. Eur J Neurol 2022; 29:2596-2606. [PMID: 35510782 PMCID: PMC9544365 DOI: 10.1111/ene.15381] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Abstract
Background and purpose Unilateral neglect is a common cognitive disorder following stroke. Neglect has a significant impact on functional outcomes, so it is important to detect. However, there is no consensus on which are the best screening tests to administer to detect neglect in time‐limited clinical environments. Methods Members of the European Academy of Neurology Scientific Panel on Higher Cortical Functions, neuropsychologists, occupational therapists, and researchers produced recommendations for primary and secondary tests for bedside neglect testing based on a rigorous literature review, data extraction, online consensus meeting, and subsequent iterations. Results A total of 512 articles were screened, and 42 were included. These reported data from 3367 stroke survivors assessed using 62 neglect screens. Tests were grouped into cancellation, line bisection, copying, reading/writing, and behavioral. Cancellation tasks were most frequently used (97.6% of studies), followed by bisection, copying, behavioral, and reading/writing assessments. The panel recommended a cancellation test as the primary screening test if there is time to administer only one test. One of several cancellation tests might be used, depending on availability. If time permits, one or more of line bisection, figure copying, and baking tray task were recommended as secondary tests. Finally, if a functional and ecological test is feasible, the Catherine Bergego Scale was recommended. Overall, the literature suggests that no single test on its own is sufficient to exclude a diagnosis of neglect. Therefore, the panel recommended that multiple neglect tests should be used whenever possible. Conclusions This study provides consensus recommendations for rapid bedside detection of neglect in real‐world, clinical environments.
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Affiliation(s)
- Margaret Moore
- Dept Experimental Psychology, University of Oxford, Oxford, UK.,Queensland Brain Institute, University of Brisbane, Brisbane, Australia
| | | | | | - Audrey Bowen
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Matthew Checketts
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, MAHSC, UK
| | - Nele Demeyere
- Dept Experimental Psychology, University of Oxford, Oxford, UK
| | | | - Olivier Godefroy
- Department of Neurology and Laboratoire de Neurosciences Fonctionnelles et Pathologies, Amiens University Medical Center, Jules Verne University of Picardy, Amiens, France
| | - Jan Laczó
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Timothy Rich
- Kessler Foundation, West Orange, New Jersey, USA & Rutgers University, Physical Medicine and Rehabilitation, Newark, New Jersey, USA
| | - Lindy Williams
- Cognitive Aging and Impairment Neurosciences Lab, University of South Australia, Adelaide, Australia
| | - Kate Woodward-Nutt
- Research and Innovation, Northern Care Alliance NHS Group, Salford, United Kingdom
| | - Masud Husain
- Dept Experimental Psychology, University of Oxford, Oxford, UK.,Nuffield Dept Clinical Neurosciences, University of Oxford, Oxford, UK
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35
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Deblock-Bellamy A, Lamontagne A, McFadyen BJ, Ouellet MC, Blanchette AK. Dual-Task Abilities During Activities Representative of Daily Life in Community-Dwelling Stroke Survivors: A Pilot Study. Front Neurol 2022; 13:855226. [PMID: 35592466 PMCID: PMC9110886 DOI: 10.3389/fneur.2022.855226] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/28/2022] [Indexed: 11/14/2022] Open
Abstract
Background In addition to several physical skills, being able to walk in the community, walking independently and safely in the community requires the ability to divide attention between walking and other tasks performed simultaneously. The aims of the present pilot study were to measure cognitive-locomotor dual-task (DT) abilities during activities representative of daily living in stroke survivors and to compare them with age- and gender-matched healthy individuals. Methods To assess DT abilities, all participants walked along a virtual shopping mall corridor and memorized a 5-item shopping list. Two levels of task complexity were used for the walking task (with or without virtual agents to avoid) and the cognitive task to recall a list of items (with or without a modification at mid-course). The assessment was conducted using an omnidirectional platform and a virtual reality (VR) headset. Locomotor and cognitive DT costs (DTC) were calculated as the percent change from single-task (ST) performance. Walking speed and minimal distance between the participant and the virtual agents were used to characterize locomotor performance. Cognitive performance was assessed by the number of correctly recalled items. One-sample Wilcoxon tests were used to determine the presence of DTCs and Mann-Whitney tests were performed to compare DTCs between the 2 groups. Results Twelve community-dwelling stroke survivors [60.50 years old (25-75th percentiles: 53.50–65.75); 5 women; 13.41 months post-stroke (5.34–48.90)] and 12 age- and gender- matched healthy individuals were recruited. Significant cognitive or mutual (cognitive and locomotor) interferences were observed in participants with stroke in all DT conditions, except the simplest (no virtual agents, no modifications to the list). For the control group, significant mutual interferences were only observed during the most complex DT condition. A group difference was detected in cognitive DTCs during the most complex DT condition (virtual agents and list modifications; p = 0.02). Stroke survivors had greater cognitive DTCs than the control group. Conclusions Using an ecological perspective contributes to understanding behavior of stroke survivors in daily activities. Virtual scenarios appear to be an interesting avenue for a more comprehensive understanding of DT abilities during activities representative of daily living in stroke survivors. The usability and feasibility of such an approach will have to be studied before considering implementation in rehabilitation settings.
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Affiliation(s)
- Anne Deblock-Bellamy
- Faculty of Medicine, Universite Laval, Quebec City, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris)–CIUSSS de la Capitale-Nationale, Quebec City, QC, Canada
| | - Anouk Lamontagne
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Jewish Rehabilitation Hospital-CISSS de Laval, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Laval, QC, Canada
| | - Bradford J. McFadyen
- Faculty of Medicine, Universite Laval, Quebec City, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris)–CIUSSS de la Capitale-Nationale, Quebec City, QC, Canada
- Department of Rehabilitation, Universite Laval, Quebec City, QC, Canada
| | - Marie-Christine Ouellet
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris)–CIUSSS de la Capitale-Nationale, Quebec City, QC, Canada
- Faculty of Social Sciences, School of Psychology, Universite Laval, Quebec City, QC, Canada
| | - Andréanne K. Blanchette
- Faculty of Medicine, Universite Laval, Quebec City, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris)–CIUSSS de la Capitale-Nationale, Quebec City, QC, Canada
- Department of Rehabilitation, Universite Laval, Quebec City, QC, Canada
- *Correspondence: Andréanne K. Blanchette
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Purpura G, Guzzetta A, Tinelli F. Visual neglect: does it exist in children with unilateral brain lesion? A systematic review. Neuropsychol Rehabil 2022; 33:703-717. [PMID: 35152851 DOI: 10.1080/09602011.2022.2032762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Visual Neglect (VN) is a common neuropsychological disorder in adults with unilateral brain lesion (UBL), characterized by the failure to attend and to report sensory events occurring in one side of space, contralateral to an area of brain damage. Less is known about VN expression in children following brain injury. The aim of this systematic review is to evaluate the presence of VN in UBL children and to identify the best neuropsychological assessment's tool for this population. A comprehensive search of 4 databases (Pubmed, Cochrane Database, SCOPUS, DARE) was undertaken from May 2020 to January 2021. Inclusion criteria were (i) subjects less than 18 years with cerebral lesions and with MRI, (ii) specific neuropsychological assessments for VN, (iii) studies published in English since 2000. A total of 309 articles were found in the initial search but only 10 observational studies met the full inclusion criteria. In these studies, 1051 subjects were evaluated for VN, of them 749 were controls and 302 had brain lesions. The two most common types of neuropsychological tools used in children with unilateral brain damage to assess the presence of VN were target cancellation tests and drawing tests.This review confirms the possibility that children with UBL can develop VN, even if it is not very clear which brain structure's characteristics can increase this risk. Children with right lesion showed visuo-spatial attention deficits focalized on the contralateral side, compatible with diagnosis of VN, while children with left lesion showed more generalized attention difficulties. The overall level of evidence correlating the presence of VN and different types of UBL in children was low and neuropsychological assessment of VN for children are sparse. Some important limitations of this review must be reported: the limited number of studies included, the administration of various types of tests to evaluate VN, the lack of information regarding the cognitive level of children in most of the studies. Further research is needed to understand patterns of VN based on brain structure and time since lesion.Systematic Review Registration: ID on PROSPERO: CRD42021281993.
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Affiliation(s)
- G. Purpura
- School of Medicine and Surgery, University of Milano Bicocca, Milano, Italy
| | - A. Guzzetta
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - F. Tinelli
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
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Villarreal S, Linnavuo M, Sepponen R, Vuori O, Bonato M, Jokinen H, Hietanen M. Computer-Based Assessment: Dual-Task Outperforms Large-Screen Cancellation Task in Detecting Contralesional Omissions. Front Psychol 2022; 12:790438. [PMID: 35069375 PMCID: PMC8777372 DOI: 10.3389/fpsyg.2021.790438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/09/2021] [Indexed: 11/18/2022] Open
Abstract
Objective: Traditionally, asymmetric spatial processing (i.e., hemispatial neglect) has been assessed with paper-and-pencil tasks, but growing evidence indicates that computer-based methods are a more sensitive assessment modality. It is not known, however, whether simply converting well-established paper-and-pencil methods into a digital format is the best option. The aim of the present study was to compare sensitivity in detecting contralesional omissions of two different computer-based methods: a "digitally converted" cancellation task was compared with a computer-based Visual and Auditory dual-tasking approach, which has already proved to be very sensitive. Methods: Participants included 40 patients with chronic unilateral stroke in either the right hemisphere (RH patients, N = 20) or the left hemisphere (LH patients, N = 20) and 20 age-matched healthy controls. The cancellation task was implemented on a very large format (173 cm × 277 cm) or in a smaller (A4) paper-and-pencil version. The computer-based dual-tasks were implemented on a 15'' monitor and required the detection of unilateral and bilateral briefly presented lateralized targets. Results: Neither version of the cancellation task was able to show spatial bias in RH patients. In contrast, in the Visual dual-task RH patients missed significantly more left-sided targets than controls in both unilateral and bilateral trials. They also missed significantly more left-sided than right-sided targets only in the bilateral trials of the Auditory dual-task. Conclusion: The dual-task setting outperforms the cancellation task approach even when the latter is implemented on a (large) screen. Attentionally demanding methods are useful for revealing mild forms of contralesional visuospatial deficits.
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Affiliation(s)
- Sanna Villarreal
- Division of Neuropsychology, HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Matti Linnavuo
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Raimo Sepponen
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Outi Vuori
- Division of Neuropsychology, HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mario Bonato
- Department of General Psychology, University of Padova, Padua, Italy
| | - Hanna Jokinen
- Division of Neuropsychology, HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marja Hietanen
- Division of Neuropsychology, HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Sato M, Mikami Y, Tajima F. Acute Occupational Therapy for a Patient with Unilateral Spatial Neglect and Difficulty in Tool Manipulation: A Case Report. Prog Rehabil Med 2022; 7:20220020. [PMID: 35495547 PMCID: PMC9002317 DOI: 10.2490/prm.20220020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/11/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Masato Sato
- Department of Rehabilitation, Hashimoto Municipal Hospital, Hashimoto, Wakayama, Japan
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Fumihiro Tajima
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
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Multiverse to inform neurological research: an example using recovery outcome of neglect. J Neurol 2022; 269:233-242. [PMID: 34052897 PMCID: PMC8739282 DOI: 10.1007/s00415-021-10612-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Multiverse analysis provides an ideal tool for understanding how inherent, yet ultimately arbitrary methodological choices impact the conclusions of individual studies. With this investigation, we aimed to demonstrate the utility of multiverse analysis for evaluating generalisability and identifying potential sources of bias within studies employing neurological populations. METHODS Multiverse analysis was used to evaluate the robustness of the relationship between post-stroke visuospatial neglect and poor long-term recovery outcome within a sample of 1113 (age = 72.5, 45.1% female) stroke survivors. A total of 25,600 t-test comparisons were run across 400 different patient groups defined using various combinations of valid inclusion criteria based on lesion location, stroke type, assessment time, neglect impairment definition, and scoring criteria across 16 standardised outcome measures. RESULTS Overall, 33.9% of conducted comparisons yielded significant results. 99.9% of these significant results fell below the null specification curve, indicating a highly robust relationship between neglect and poor recovery outcome. However, the strength of this effect was not constant across all comparison groups. Comparisons which included < 100 participants, pre-selected patients based on lesion type, or failed to account for allocentric neglect impairment were found to yield average effect sizes which differed substantially. Similarly, average effect sizes differed across various outcome measures with the strongest average effect in comparisons involving an activities of daily living measure and the weakest in comparisons employing a depression subscale. CONCLUSIONS This investigation demonstrates the utility of multiverse analysis techniques for evaluating effect robustness and identifying potential sources of bias within neurological research.
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Hougaard BI, Knoche H, Jensen J, Evald L. Spatial Neglect Midline Diagnostics From Virtual Reality and Eye Tracking in a Free-Viewing Environment. Front Psychol 2021; 12:742445. [PMID: 34912268 PMCID: PMC8667868 DOI: 10.3389/fpsyg.2021.742445] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/19/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose: Virtual reality (VR) and eye tracking may provide detailed insights into spatial cognition. We hypothesized that virtual reality and eye tracking may be used to assess sub-types of spatial neglect in stroke patients not readily available from conventional assessments. Method: Eighteen stroke patients with spatial neglect and 16 age and gender matched healthy subjects wearing VR headsets were asked to look around freely in a symmetric 3D museum scene with three pictures. Asymmetry of performance was analyzed to reveal group-level differences and possible neglect sub-types on an individual level. Results: Four out of six VR and eye tracking measures revealed significant differences between patients and controls in this free-viewing task. Gaze-asymmetry between-pictures (including fixation time and count) and head orientation were most sensitive to spatial neglect behavior on a group level analysis. Gaze-asymmetry and head orientation each identified 10 out of 18 (56%), compared to 12 out of 18 (67%) for the best conventional test. Two neglect patients without deviant performance on conventional measures were captured by the VR and eyetracking measures. On the individual level, five stroke patients revealed deviant gaze-asymmetry within-pictures and six patients revealed deviant eye orientation in either direction that were not captured by the group-level analysis. Conclusion: This study is a first step in using VR in combination with eye tracking measures as individual differential neglect subtype diagnostics. This may pave the way for more sensitive and elaborate sub-type diagnostics of spatial neglect that may respond differently to various treatment approaches.
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Affiliation(s)
- Bastian I Hougaard
- Department of Architecture and Media Technology, Aalborg University, Aalborg, Denmark
| | - Hendrik Knoche
- Department of Architecture and Media Technology, Aalborg University, Aalborg, Denmark
| | | | - Lars Evald
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
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Dubé C, Jin Y, Powers BG, Li G, Labelle A, Rivers MS, Gumboc IM, Bussières AE. Vision Evaluation Tools for Adults With Acquired Brain Injury: A Scoping Review. Can J Occup Ther 2021; 88:340-351. [PMID: 34658251 PMCID: PMC8640270 DOI: 10.1177/00084174211042955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background. Unrecognized visual deficits (VDs) following an acquired brain injury (ABI) may impact clients' rehabilitation. Little is known about evaluation tools used in vision rehabilitation. Purpose. To systematically explore the literature describing evaluation tools used for VD on adults with ABI. Method. Using a scoping review methodology, we searched in MEDLINE(Ovid), Embase, CINAHL, PsycINFO, and the grey literature from inception to 2020. Quantitative and thematic analyses were performed. Findings. Of the 83 studies reporting on 86 evaluation tools, 47% used multiple tools to assess VD. Tools were mostly used by occupational therapists and psychologists to evaluate intermediate, intermediate to high, and high-level visual skills. Clinicians tend to select specific tools that focus on different levels of the hierarchy of visual skills. Implications. Future research should investigate the optimal timeframe for assessment of VD and the psychometric properties of tools to ensure comprehensive VD evaluation.
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Affiliation(s)
- Camille Dubé
- Corresponding author: Camille Dubé,
McGill University Faculty of Medicine, School of Physical and Occupational Therapy, 3654
Prom Sir-William-Osler, Hosmer House 205, Montreal, QC H3G 1Y5, Canada.
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Scheffels JF, Korabova S, Eling P, Kastrup A, Hildebrandt H. The Effects of Continuous vs. Intermittent Prism Adaptation Protocols for Treating Visuospatial Neglect: A Randomized Controlled Trial. Front Neurol 2021; 12:742727. [PMID: 34867725 PMCID: PMC8639507 DOI: 10.3389/fneur.2021.742727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Visuospatial neglect may interfere with activities of daily living (ADL). Prism adaptation (PA) is one treatment option and may involve two components: recalibration (more strategic) and realignment (more implicit). We examined whether recalibration or realignment is the driving force in neglect rehabilitation using PA. In a randomized controlled trial with two recruitment series and a cross-over design, 24 neglect patients were allocated to a continuous (PA-c) or intermittent (PA-i) PA procedure. During the PA-c condition, goggles were worn without doffing. In the PA-i condition, patients donned goggles twice (first series of patients) or three times (second series) during training to induce more recalibrations. Primary outcome parameters were performance (omissions) on the Apples Cancellation Test and ADL scores. To assess the efficacy of the PA treatment, we compared effect sizes of the current study with those from three groups from previous studies at the same rehabilitation unit: (1) a passive treatment with a similar intensity, (2) a placebo treatment with a similar intensity, and (3) a PA treatment with fewer therapy sessions. Treatment conditions did not significantly predict scores on primary and most secondary outcome parameters. However, the spontaneous ipsilesional body orientation improved only in patients receiving the PA-i condition and this improvement also appeared in patients showing a strong after-effect (irrespective of condition). Effect sizes for the Apples Cancellation Test and the Functional Independence Measure were larger for both PA treatment protocols than the historical control groups. We conclude that more recalibrations during an intermittent PA treatment may have a beneficial effect on spontaneous body orientation but not on other aspects of neglect or on ADL performance. Clinical Trial Registration: German Clinical Trials Register, identifier: DRKS00018813, DRKS00021539.
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Affiliation(s)
- Jannik Florian Scheffels
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
| | - Sona Korabova
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
| | - Paul Eling
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
| | - Andreas Kastrup
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
| | - Helmut Hildebrandt
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
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de la Piedra Walter M, Notbohm A, Eling P, Hildebrandt H. Audiospatial evoked potentials for the assessment of spatial attention deficits in patients with severe cerebrovascular accidents. J Clin Exp Neuropsychol 2021; 43:623-636. [PMID: 34592915 DOI: 10.1080/13803395.2021.1984397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Neuropsychological assessment of spatial orientation in post-acute patients with large brain lesions is often limited due to additional cognitive disorders like aphasia, apraxia, or reduced responsiveness. METHODS To cope with these limitations, we developed a paradigm using passive audiospatial event-related potentials (pAERPs): Participants were requested to merely listen over headphones to horizontally moving tones followed by a short tone ("target"), presented either on the side to which the cue moved or on the opposite side. Two runs of 120 trials were presented and we registered AERPs with two electrodes, mounted at C3 and C4. Nine sub-acute patients with large left hemisphere (LH) or right hemisphere (RH) lesions and nine controls participated. RESULTS Patients had no problems completing the assessment. RH patients showed a reduced N100 for left-sided targets in all conditions. LH patients showed a diminished N100 for invalid trials and contralesional targets. CONCLUSION Measuring AERPs for moving auditory cues and with two electrodes allows investigating spatial attentional deficits in patients with large RH and LH lesions, who are often unable to perform clinical tests. Our procedure can be implemented easily in an acute and rehabilitation setting and might enable investigating spatial attentional processes even in patients with minimal conscious awareness.
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Affiliation(s)
| | - Annika Notbohm
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
| | - Paul Eling
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Helmut Hildebrandt
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany.,Institute of Psychology, University of Oldenburg, Oldenburg, Germany
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Moore MJ, Vancleef K, Riddoch MJ, Gillebert CR, Demeyere N. Recovery of Visuospatial Neglect Subtypes and Relationship to Functional Outcome Six Months After Stroke. Neurorehabil Neural Repair 2021; 35:823-835. [PMID: 34269128 PMCID: PMC8414826 DOI: 10.1177/15459683211032977] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background/Objective. This study aims to investigate how complex visuospatial neglect behavioural phenotypes predict long-term outcomes, both in terms of neglect recovery and broader functional outcomes after 6 months post-stroke. Methods. This study presents a secondary cohort study of acute and 6-month follow-up data from 400 stroke survivors who completed the Oxford Cognitive Screen's Cancellation Task. At follow-up, patients also completed the Stroke Impact Scale questionnaire. These data were analysed to identify whether any specific combination of neglect symptoms is more likely to result in long-lasting neglect or higher levels of functional impairment, therefore warranting more targeted rehabilitation. Results. Overall, 98/142 (69%) neglect cases recovered by follow-up, and there was no significant difference in the persistence of egocentric/allocentric (X2 [1] = .66 and P = .418) or left/right neglect (X2 [2] = .781 and P = .677). Egocentric neglect was found to follow a proportional recovery pattern with all patients demonstrating a similar level of improvement over time. Conversely, allocentric neglect followed a non-proportional recovery pattern with chronic neglect patients exhibiting a slower rate of improvement than those who recovered. A multiple regression analysis revealed that the initial severity of acute allocentric, but not egocentric, neglect impairment acted as a significant predictor of poor long-term functional outcomes (F [9,300] = 4.742, P < .001 and adjusted R2 = .098). Conclusions. Our findings call for systematic neuropsychological assessment of both egocentric and allocentric neglect following stroke, as the occurrence and severity of these conditions may help predict recovery outcomes over and above stroke severity alone.
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Affiliation(s)
- Margaret J. Moore
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Kathleen Vancleef
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - M. Jane Riddoch
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | | | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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Left egocentric neglect in early subacute right-stroke patients is related to damage of the superior longitudinal fasciculus. Brain Imaging Behav 2021; 16:211-218. [PMID: 34328618 PMCID: PMC8825605 DOI: 10.1007/s11682-021-00493-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 11/16/2022]
Abstract
A typical consequence of stroke in the right hemisphere is unilateral spatial neglect. Distinct forms of neglect have been described, such as space-based (egocentric) and object-based (allocentric) neglect. However, the relationship between these two forms of neglect is still far from being understood, as well as their neural substrates. Here, we further explore this issue by using voxel lesion symptoms mapping (VLSM) analyses on a large sample of early subacute right-stroke patients assessed with the Apples Cancellation Test. This is a sensitive test that simultaneously measures both egocentric and allocentric neglect. Behaviourally, we found no correlation between egocentric and allocentric performance, indicating independent mechanisms supporting the two forms of neglect. This was confirmed by the VLSM analysis that pointed out a link between a damage in the superior longitudinal fasciculus and left egocentric neglect. By contrast, no association was found between brain damage and left allocentric neglect. These results indicate a higher probability to observe egocentric neglect as a consequence of white matter damages in the superior longitudinal fasciculus, while allocentric neglect appears more “globally” related to the whole lesion map. Overall, these findings on early subacute right-stroke patients highlight the role played by white matter integrity in sustaining attention-related operations within an egocentric frame of reference.
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Terruzzi S, Crivelli D, Campana E, Pisoni A, Romero Lauro LJ, Bolognini N, Vallar G. Exploring the time-course and the reference frames of adaptation to optical prisms and its aftereffects. Cortex 2021; 141:16-35. [PMID: 34023799 DOI: 10.1016/j.cortex.2021.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/25/2020] [Accepted: 04/13/2021] [Indexed: 11/28/2022]
Abstract
Prism adaptation (PA) is used to investigate visuo-motor plasticity and to rehabilitate the syndrome of Unilateral Spatial Neglect (USN). After PA, participants show aftereffects (AEs), contralateral to the side of the optical displacement in several tasks. This study explored the features of these AEs, specifically the "egocentric" versus "allocentric, object-based", reference frames involved, and their time course. In three experiments, healthy participants adapted to prismatic lenses inducing a horizontal displacement of the visual field. In Experiment #1, participants adapted to rightward displacing prisms. Four tasks were used requiring repeated pointings towards the participant's subjective egocentric straight-ahead, with the availability of proprioceptive or visual-proprioceptive signals, and, in some conditions, of an external allocentric visual frame (i.e., a rectangular paper sheet). Experiment #2 explored the role of the position of the allocentric frame, with AEs being tested by straight-ahead and frame bisection tasks, requiring pointing toward the external visual frame, placed in different positions of the working space. An egocentric visual proprioceptive task was administered after prism removal and after the execution of the allocentric tasks, to assess the effectiveness of the PA, as indexed by the AEs, and their persistence up to the end of the administration of the allocentric tasks. Experiment #3 differed from #2 in that participants adapted to leftward displacing lenses. Consistent with evidence from USN patients, in Experiment #1, in the egocentric tasks, AEs lasting up to 30 min after PA were found. In Experiment #2, AEs in "allocentric" tasks did not occur, regardless of frame position. Experiment #3 showed AEs in both the "egocentric" and the "allocentric" tasks, with the latter being minor in size. These findings illustrate that the spatial reference systems modulated by PA in extra-personal space primarily operate in spatial "egocentric" reference frames, with a comparatively minor and direction-specific role of "allocentric" frames.
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Affiliation(s)
- Stefano Terruzzi
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; CeRiN, University of Trento, Rovereto, Italy.
| | - Damiano Crivelli
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Elena Campana
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; Neuropsychological Unit, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Alberto Pisoni
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | - Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; Neuropsychological Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Vallar
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; Neuropsychological Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Auxologico Italiano, Milan, Italy.
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Turgut N, Jansen AL, Nielsen J, Heber I, Eling P, Hildebrandt H. Repeated application of the covert shift of attention task improves endogenous but not exogenous attention in patients with unilateral visuospatial inattention. Brain Cogn 2021; 151:105732. [PMID: 33895466 DOI: 10.1016/j.bandc.2021.105732] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/04/2021] [Accepted: 04/06/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Most neglect treatment studies focus on automatic re-orientation procedures, assuming a deficit in automatic processes. We compare an automatic- and a controlled procedure, using the endogenous and exogenous variants of Posner's covert shift of attention task. METHOD In two experiments, neglect patients and patients with a right hemispherical stroke without neglect performed three blocks of Posner's covert shift of attention task (Posner Task) on two days. In Study 1 we used endogenous cues, in Study 2, exogenous cues. RESULTS In the endogenous task, neglect patients improved significantly with valid left-sided cues between block 1 and 2 on Day 1, subsequently showing a plateauing. They also showed a gradual improvement on invalid trials on both days. In the exogenous condition, all participants responded only increasingly faster on trials with a long stimulus onset asynchrony. Practicing on both tasks led to fewer omissions for left-sided targets, minimally in the exogenous and clearly in the endogenous condition. CONCLUSION In line with prior neuroanatomical studies, our study shows that practicing an endogenous, but not an exogenous, visuospatial attention task leads to significant improvements in neglect patients, especially for invalid trials, suggesting that neglect treatments based on top-down strategies should be given more attention.
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Affiliation(s)
- Nergiz Turgut
- Instituto de Neurociencias, Universidad San Francisco de Quito, Quito, Ecuador
| | - Anna-Lena Jansen
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
| | - Jörn Nielsen
- Department of Cognitive Rehabilitation, Neurological Rehabilitation Centre Godeshöhe, Bonn, Germany; Department of Medical Psychology
- Neuropsychology and Gender Studies, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Ines Heber
- Department of Neurological Rehabilitation, Median Klinik Wilhelmshaven, Wilhelmshaven, Germany
| | - Paul Eling
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, the Netherlands
| | - Helmut Hildebrandt
- Department of Psychology, University of Oldenburg, Oldenburg, Germany; Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany.
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Daini R, Primativo S, Albonico A, Veronelli L, Malaspina M, Corbo M, Martelli M, Arduino LS. The Focal Attention Window Size Explains Letter Substitution Errors in Reading. Brain Sci 2021; 11:247. [PMID: 33669454 PMCID: PMC7920487 DOI: 10.3390/brainsci11020247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/30/2021] [Accepted: 02/12/2021] [Indexed: 11/16/2022] Open
Abstract
Acquired Neglect Dyslexia is often associated with right-hemisphere brain damage and is mainly characterized by omissions and substitutions in reading single words. Martelli et al. proposed in 2011 that these two types of error are due to different mechanisms. Omissions should depend on neglect plus an oculomotor deficit, whilst substitutions on the difficulty with which the letters are perceptually segregated from each other (i.e., crowding phenomenon). In this study, we hypothesized that a deficit of focal attention could determine a pathological crowding effect, leading to imprecise letter identification and consequently substitution errors. In Experiment 1, three brain-damaged patients, suffering from peripheral dyslexia, mainly characterized by substitutions, underwent an assessment of error distribution in reading pseudowords and a T detection task as a function of cue size and timing, in order to measure focal attention. Each patient, when compared to a control group, showed a deficit in adjusting the attentional focus. In Experiment 2, a group of 17 right-brain-damaged patients were asked to perform the focal attention task and to read single words and pseudowords as a function of inter-letter spacing. The results allowed us to confirm a more general association between substitution-type reading errors and the performance in the focal attention task.
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Affiliation(s)
- Roberta Daini
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (A.A.); (M.M.)
- COMiB—Optics and Optometry Research Center, Università degli studi di Milano-Bicocca & NeuroMI—Milan Center for Neuroscience, 20126 Milan, Italy
| | - Silvia Primativo
- Department of Human Sciences, LUMSA University, 00193 Rome, Italy; (S.P.); (L.S.A.)
| | - Andrea Albonico
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (A.A.); (M.M.)
- Departments of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC V5Z 3N9, Canada
| | - Laura Veronelli
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, 20144 Milan, Italy; (L.V.); (M.C.)
| | - Manuela Malaspina
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (A.A.); (M.M.)
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, 20144 Milan, Italy; (L.V.); (M.C.)
| | - Marialuisa Martelli
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy;
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Lisa S. Arduino
- Department of Human Sciences, LUMSA University, 00193 Rome, Italy; (S.P.); (L.S.A.)
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Chen P, Toglia J. The 3s Spreadsheet Test version 2 for assessing egocentric viewer-centered and allocentric stimulus-centered spatial neglect. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1369-1379. [PMID: 33556259 DOI: 10.1080/23279095.2021.1878462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The present study established the norms of the 3 s Spreadsheet Test version 2 (3S-v2 Test) with 186 healthy adults, compared performance of 23 individuals with spatial neglect after right brain stroke to the norms, and examined the extent that allocentric neglect is independent from egocentric neglect. The task required in the 3S-v2 Test is to cross out the target digit "3" in a spreadsheet that contained 10 columns and 14 rows of digit strings, including 120 target digits and 720 non-target digits. Each target is categorized with respect to its location on the page (egocentric viewer-centered) and its position within the digit string (allocentric stimulus-centered). Patients completed the 3S-v2 Test, the Apples Test, and Scene Copying Test (a five-object figure copying test). Based on the neglect classification criteria of these three tests, 18 patients (78.3%) were identified with both forms of neglect, three patients (13.0%) had isolated egocentric neglect, and two (8.7%) had isolated allocentric neglect. Among patients who were determined as having allocentric neglect by a given test, we found no significant correlation between severity of allocentric neglect and stimulus location in the egocentric reference frame. Based on the present findings, we suggest that including the 3S-v2 Test, a functionally relevant task and different from the currently available tests, may increase the comprehensiveness of neglect assessment. In addition, allocentric neglect symptoms are independent of egocentric locations.
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Affiliation(s)
- Peii Chen
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University, Newark, NJ, USA
| | - Joan Toglia
- School of Health and Natural Sciences, Mercy College, Dobbs Ferry, NY, USA.,Rehabilitation Medicine Department, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
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Pierce JE, Ronchi R, Thomasson M, Rossi I, Casati C, Saj A, Vallar G, Vuilleumier P. A novel computerized assessment of manual spatial exploration in unilateral spatial neglect. Neuropsychol Rehabil 2021; 32:1099-1120. [PMID: 33478363 DOI: 10.1080/09602011.2021.1875850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Unilateral spatial neglect is a neuropsychological syndrome commonly observed after stroke and defined by the inability to attend or respond to contralesional stimuli. Typically, symptoms are assessed using clinical tests that rely upon visual/perceptual abilities. However, neglect may affect high-level representations controlling attention in other modalities as well. Here we developed a novel manual exploration test using a touch screen computer to quantify spatial search behaviour without visual input. Twelve chronic stroke patients with left neglect and 27 patients without neglect (based on clinical tests) completed our task. Four of the 12 "neglect" patients exhibited clear signs of neglect on our task as compared to "non-neglect" patients and healthy controls, and six other patients (from both groups) also demonstrated signs of neglect compared to healthy controls only. While some patients made asymmetrical responses on only one task, generally, patients with the strongest neglect performed poorly on multiple tasks. This suggests that representations associated with different modalities may be affected separately, but that severe forms of neglect are more likely related to damage in a common underlying representation. Our manual exploration task is easy to administer and can be added to standard neglect screenings to better measure symptom severity.
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Affiliation(s)
- Jordan E Pierce
- Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva, Switzerland
| | - Roberta Ronchi
- Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva, Switzerland.,Department of Clinical Neurosciences, University Hospital of Geneva, Switzerland
| | - Marine Thomasson
- Department of Clinical Neurosciences, University Hospital of Geneva, Switzerland.,Clinical and Experimental Neuropsychology Laboratory, Department of Psychology and Educational Sciences, University of Geneva, Switzerland
| | - Irene Rossi
- Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milano, Italy.,Dept. of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Carlotta Casati
- Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milano, Italy.,Dept. of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Arnaud Saj
- Department of Psychology, University of Montreal, Canada
| | - Giuseppe Vallar
- Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milano, Italy.,Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Patrik Vuilleumier
- Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva, Switzerland
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