Automated Video Tracking To Assess Executive Aspects of Cancellation in Stroke (P02.031)

Abstract

Objective: To evaluate the feasibility of automated video-based tracking of pen movement by stroke patients during standard cancellation assessment. Background Although the cancellation test is widely used to assess unilateral spatial neglect, attempts to quantify the self-organization of visual search on cancellation (an executive function) are often frustrated either by the need for laborious monitoring by the examiner or technological limitations of touchscreen-based assessments due to limb apraxia. We evaluated whether automated video tracking of pen movements during pen-and-paper cancellation could overcome these difficulties. Design/Methods: Five stroke patients (4 left infarct, 1 right infarct) were video recorded on the Star Cancellation Test with a fluorescent marker at the pen tip. EthoVision XT 8.0 software was used to calculate the regression coefficient ( r ) of both the x - and y -coordinates of all sequential points of changes in pen direction during testing. The greater r- value from each patient was used to represent the extent of search organization. Results were compared to three healthy age-similar adults. Results: All subjects complied with testing. 4/5 patients9 r -values fell outside of control subject range ( r 9s r = 0.52 ). Conclusions: Results suggest that (1) video tracking software easily computes search organization on cancellation, (2) marked aphasia does not preclude test compliance, and (3) aphasic patients may be better organized than stroke patients with left spatial neglect, despite profound comprehension impairment. Video tracking of cancellation may afford a simple, non-intrusive way to assess executive aspects of visual search in stroke. In addition, because this method computes changes in pen movement including above the test array, this may constitute a new index of self-organization during search that may be relevant to functional outcomes. Disclosure: Dr. Mark has nothing to disclose. Dr. Chasan has nothing to disclose.