Abstract
We tested a group of ten post-acute right-hemisphere damaged patients. Patients had no neglect according to paper-and-pencil cancellation tasks. They were administered computer-based single- and dual-tasks, requiring to orally name the position of appearance (e.g. left vs. right) of briefly-presented lateralized targets. Patients omitted a consistent number of contralesional targets (≈ 40%) under the single-task condition. When required to perform a concurrent task which recruited additional attentional resources (dual-tasks), patients’ awareness for contralesional hemispace was severely affected, with less than one third of contralesional targets detected (≈ 70% of omissions). In contrast, performance for ipsilesional (right-sided) targets was close to ceiling, showing that the deficit unveiled by computer-based testing selectively affected the contralesional hemispace. We conclude that computer-based, attention-demanding tasks are strikingly more sensitive than cancellation tasks in detecting neglect, because they are relatively immune to compensatory strategies that are often deployed by post-acute patients.
Highlights
After a brain lesion, the presence and the severity of contralesional neglect is highly variable across patients and is modulated by several factors, including time from onset and assessment methods [1]
In the first days following the occurrence of a neurological insult, patients often omit targets in the contralesional hemispace on paper-and-pencil cancellation tests
A group of patients with right-hemisphere damage, the sensitivity of cancellation tests [2], which are the gold standard for neglect assessment [3], with that of a recent computer-based demanding paradigm [4,5] for the detection of contralesional awareness deficits
Summary
The presence and the severity of contralesional neglect is highly variable across patients and is modulated by several factors, including time from onset and assessment methods [1]. With increasing time from lesion, the majority of patients can successfully detect the most contralesional targets on cancellation tests; this improvement generally applies to other diagnostic tests of neglect. We directly compared, in a group of patients with right-hemisphere damage, the sensitivity of cancellation tests [2], which are the gold standard for neglect assessment [3], with that of a recent computer-based demanding paradigm [4,5] for the detection of contralesional awareness deficits. Our aim was to show that, in the post-acute phase, severe neglect can (re)emerge in apparently intact patients when more sensitive tasks were adopted
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