Computer-Based Assessment: Dual-Task Outperforms Large-Screen Cancellation Task in Detecting Contralesional Omissions.

Sanna Villarreal,Hanna Jokinen,Raimo Sepponen,Outi Vuori,Matti Linnavuo,Mario Bonato,Marja Hietanen

doi:10.3389/fpsyg.2021.790438

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.

Highlights

Hemispatial neglect is a heterogenous and multicomponential syndrome encompassing several attentional and spatial deficits (Husain, 2019)
It is often associated to contralesional omissions occurring in contexts of competition for selection, as well as to non-lateralized attention deficits (Kerkhoff, 2001; Husain, 2019)
We developed a new computer-based large-screen cancellation task and compared it with a computerbased dual-task approach with brief stimulus duration, which has already proven to be more sensitive than paper-and-pencil tasks in detecting contralesional omissions (Bonato et al, 2010, 2012; Bonato, 2015; Blini et al, 2016; Andres et al, 2019)

Summary

Introduction

Hemispatial neglect is a heterogenous and multicomponential syndrome encompassing several attentional and spatial deficits (Husain, 2019). To prevent compensation and to identify milder deficits, time limits are sometimes introduced (Priftis et al, 2019) Another possibility is to calculate indices that are more sophisticated than the simple number of omissions, such as the starting point analysis (Azouvi et al, 2002; Nurmi et al, 2010, 2018), which allows quantifying neglect patients’ tendency to start visual searching from the ipsilesional hemispace (Kinsbourne, 1987; Karnath, 1988; Olk et al, 2002)

Methods

Results

Conclusion