Abstract
Spatial neglect has been shown to occur in 17–65% of patients after acute left-hemispheric stroke. One reason for this varying incidence values might be that left-hemispheric stroke is often accompanied by aphasia, which raises difficulties in assessing attention deficits with conventional neuropsychological tests entailing verbal instructions. Video-oculography during free visual exploration (FVE) requires only little understanding of simple non-verbal instruction and has been shown to be a sensitive and reliable tool to detect spatial neglect in patients with right-hemispheric stroke. In the present study, we aimed to investigate the feasibility of FVE to detect neglect in 10 left-hemispheric stroke patients with mild to severe aphasia as assessed by means of the Token Test, Boston Naming Test and Aachener Aphasie Test. The patient’s individual deviation between eye movement calibration and validation was recorded and compared to 20 age-matched healthy controls. Furthermore, typical FVE parameters such as the landing point of the first fixation, the mean gaze position (in ° of visual angle), the number and duration of visual fixations and the mean visual exploration area were compared between groups. In addition, to evaluate for neglect, the Bells cancellation test was performed and neglect severity in daily living was measured by means of the Catherine Bergego Scale (CBS). Our results showed that the deviation between calibration and validation did not differ between aphasia patients and healthy controls highlighting its feasibility. Furthermore, FVE revealed the typical neglect pattern with a significant leftward shift in visual exploration bahaviour, which highly correlated with neglect severity as assessed with CBS. The present study provides evidence that FVE has the potential to be used as a neglect screening tool in left-hemispheric stroke patients with aphasia in which compliance with verbal test instructions may be compromised by language deficits.
Highlights
Spatial neglect, as assessed with classic neuropsychological paper-pencil tests, has been reported to occur in 17–65% of patients after left-hemispheric stroke (Stone et al, 1993; Beis et al, 2004; Ringman et al, 2004; Beume et al, 2017)
The aim of the present study was to test this hypothesis, i.e., administer a commonly used free visual exploration (FVE) paradigm (Delazer et al, 2018; Paladini et al, 2019; Kaufmann et al, 2020a) in order to assess the feasibility of applying video-oculography to detect right-sided neglect in left-hemispheric stroke patients with aphasia
We show that video-oculography during a FVE paradigm is a feasible approach to evaluate right-sided neglect in left-hemispheric stroke patients with aphasia
Summary
As assessed with classic neuropsychological paper-pencil tests, has been reported to occur in 17–65% of patients after left-hemispheric stroke (Stone et al, 1993; Beis et al, 2004; Ringman et al, 2004; Beume et al, 2017). In patients with right-hemispheric stroke, video-oculography during free visual exploration (FVE) has increasingly become a valuable screening tool to detect left-sided neglect after a righthemispheric lesion. In this context, the assessment of the spatial distribution of visual fixations along the horizontal axis during FVE, reflecting the spatial allocation of visual attention, has proved as a suitable indicator (e.g., Pflugshaupt et al, 2004; Nyffeler et al, 2008; Ptak et al, 2009; Cazzoli et al, 2011; Osandón et al, 2012; Müri et al, 2013; Fellrath and Ptak, 2015; Paladini et al, 2019; Kaufmann et al, 2020a,b). It seems reasonable to assume that eye-tracking during FVE can be successfully applied in patients with aphasia after a left-hemispheric lesion in order to detect right-sided neglect
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