Rey-Osterrieth complex figure (ROCF) tracing task for evaluating unilateral spatial neglect

Abstract

Unilateral spatial neglect (USN) is often observed in right brain-damaged (RBD) patients but it is a poor prognostic factor for predicting recovery of activities of daily living. In this study, we devised a convenient and quantitative test for evaluating USN, the Rey-Osterrieth Complex Figure (ROCF) tracing task, and examined its usefulness. The subjects were 40 healthy volunteers (21 males; mean age 58.9 years, SD 15.6) and 21 RBD patients (15 males; mean age 54.3 years, SD 10.1). After carrying out the task of copying ROCF, subjects underwent the task of tracing ROCF laid over carbon paper by using a chopstick so as not to leave lines directly on the ROCF. The RBD patients also carried out traditional tests for evaluating USN: the line bisection test, the line cancellation test, and a star cancellation test from the Japanese version of the Behavioral Inattention Test (BIT). We quantified results of both the copying and tracing tasks with the total score (Osterrieth, 1944) and the Laterality index (LI) (Jeffrey S 1995, 2001). We set the cut-off values for total score and LI to 2 SD below their averages in the healthy group. Of the 21 RBD patients, 5 had USN as judged with the traditional tests. However, with the ROCF tracing task, the total scores of 6 patients and the LIs of 9 patients were below the cut-off values. Furthermore, with the ROCF tracing task, in one RBD patient USN was revealed that had not appeared in the ROCF copying task, and in another patient USN was revealed more clearly than with copying because of a decrease of constructive apraxia. The ROCF tracing task might quantify certain aspects of movement memory in the neglect syndrome and detect USN with greater sensitivity than the traditional tests.