Albert's Test Research Articles

Feasibility of Computerized Visuomotor Integration System for Visual Field Defects and Spatial Neglect in Poststroke Patients.

To develop a computerized visuomotor integration system for assessment and training of visual perception impairments and evaluate its safety and feasibility in patients with a stroke. Visual field defects and spatial neglect lead to substantial poststroke impairment. Most diagnostic assessments are anchored in traditional methods, and clinical effects of rehabilitation treatments are limited. The CoTras Vision system included two evaluations and four training modules. The evaluation modules were based on the Albert's test and Star cancellation test, and training modules were based on visual tracking, central-peripheral integration, and visuomotor perception techniques. Bland-Altman plots for agreement with the traditional paper-and-pencil test were performed, and the modified Intrinsic Motivation Inventory, Patient Satisfaction Questionnaire, and Simulator Sickness Questionnaire were conducted. Ten patients with acute stroke completed the study. Bland-Altman plots revealed good agreements for Albert's test (mean difference, -0.3±4.5) and Star cancellation test (mean difference, 0.3±0.7). The mean±standard deviation scores of the modified Intrinsic Motivation Inventory, Patient Satisfaction Survey, and Simulator Sickness Questionnaire were 84.7±30.6, 40.5±7.9, and 34.0±34.5 respectively. The CoTras Vision system is feasible and safe in patients with stroke. Most patients had a high degree of motivation to use the system and did not experience severe adverse events. Further studies are needed to confirm its usefulness in stroke patients with visual field defects and hemineglect symptoms. Furthermore, a large, well-designed, randomized controlled trial will be needed to confirm the treatment effect of the CoTras Vision system.

Association between sensation, perception, negative socio-psychological factors and cognitive impairment

BackgroundEvidence has suggested that sensation and socio-psychological factors may be associated with cognitive impairment separately in older adults. However, the association between those risk factors and cognitive impairment is still unknown. ObjectiveTo investigate the association between sensation, perception, negative socio-psychological factors, and cognitive impairment in institutionalized older adults. MethodsFrom two public aged care facilities, 215 participants were investigated. The Mini-mental State Examination was applied to assess cognitive function. The sensory function was bifurcated into auditory and somatosensory realms which were evaluated using pure tone audiometry and Nottingham Sensory Assessment, respectively. Albert's test, left and right resolution, and visuospatial distribution were used to evaluate perception. Depression and social isolation were selected as negative socio-psychological factors and were evaluated by the Geriatric Depression Scale and the Lubben Social Network Scale. The multivariate analysis was performed utilizing binary logistic regression. ResultsParticipants with moderately severe or severe hearing loss exhibited significant cognitive impairment compared to those with mild hearing loss. It was observed that perceptual dysfunction and depression were independently related to cognitive impairment. However, there was no significant association between somatosensory function, social isolation, and cognitive impairment in the institutionalized older adults. ConclusionMore profound hearing loss, abnormal perception, and depression are associated with cognitive impairment in older adults. Subsequent research endeavors should delve into the causal mechanisms underpinning these associations and explore whether combined interventions have the potential to postpone the onset of cognitive impairment.

Treating Visual Inattention in Acute Stroke Survivors Using a Therapy Scanning Wall: A Proof-of-Concept Study.

Visual inattention is common following right hemisphere stroke, with up to 80% of patients being affected. Visual inattention following stroke is linked to poorer outcomes. There is no clear evidence for how visual inattention should be treated in the hospital inpatient setting. To explore the practical implications and possible benefits of using a visual scanning wall in a stroke rehabilitation unit as an assessment and treatment tool for visual inattention. This proof-of-concept study recruited stroke survivors with visual inattention. Participants used the scanning wall for scanning training five days a week for two weeks. Assessments using the scanning wall and modified Albert's test were conducted at baseline and at day 14. Both participants and staff delivering the training were asked to complete an acceptability questionnaire. All participants demonstrated an improvement in the number of pictures identified from baseline to day 14. There was a mean improvement of 9.20 (95% CI 4.77 to 13.63) in the 14 days. This is a statistically significant improvement in the scanning wall score between baseline line and day 14 (p = 0.01). All participants and staff reported the scanning wall as acceptable to use. This proof-of-concept study has demonstrated the scanning wall could be used to assess for visual inattention in extra personal space. Also, it could be beneficial and is acceptable for the treatment of visual inattention within a hospital inpatient setting for acute stroke survivors.

Correlation of Hemispatial Neglect with White Matter Tract Integrity: A DTI Study.

We investigated the diffusion tensor image (DTI) parameters of superior longitudinal fasciculus (SLF) and inferior fronto-occipital fasciculus (IFOF), and their relationships with hemispatial neglect. Thirteen patients with first-ever ischemic stroke who had the right hemispheric lesion were included. Neglect was assessed using the Albert test and figure discrimination test of Motor-free Visual Perception Test 3 (MVPT-3). The SLF and IFOF were separated by diffusion tensor tractography (DTT) and tract volume (TV) was calculated. We measured the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in the total area, seed region of interest (ROI), and target ROI, respectively. Among thirteen patients, seven demonstrated signs of hemispatial neglect on neglect test. Tractography reconstruction showed significantly low TV of the right IFOF in patients with hemispatial neglect. FA values of the right SLF and the right IFOF were significantly lower in neglect patients. ADC values were not significantly different in two groups. This study suggests that damage of SLF and IFOF is associated with hemispatial neglect in right hemispheric stroke patients. DTI may be useful for predicting the severities of hemispatial neglect using values such as TV and FA of each tract.

Robotic Rehabilitation Effect on Unilateral Spatial Neglect in Patients With Acute Stroke

Research Objectives 1. Determining if the InMotion2 Robot can be useful in alleviating unilateral spatial neglect 2. To understand if deficits with theoretical relationship can be addressed at the same time during the intervention (Muscle activation and Unilateral Spatial Neglect) 3. To determine the effect of early intervention to alleviate unilateral spatial neglect. Design Quasi-Experimental design with test - posttest. Setting Inpatient Rehabilitation. Participants A sample of convenience through consecutive sampling was used for this study and setting. The sample was derived from patients admitted to the Rehabilitation Institute due to a new onset of stroke, and exhibiting signs of unilateral spatial neglect, as determined by Albert's test, Star Cancellation and Catherine Bergego's Scale. 23 met the inclusion criteria. 16 completed the study with five in Robotic (treatment) group and eleven in control group. Interventions Both groups received conventional therapy, but the Robotic (treatment) group also received an extra 30 minutes of robotic training for ten days within the first two weeks of rehabilitation. The conventional therapy entailed training in activities of daily living, muscle activation and midline orientation. Robotic treatment entailed computer games with targets acquired through the interactive movement of robot with visual feed back. Main Outcome Measures Catherine Bergego's Scale, Functional Independence Measure, Star Cancellation, and Albert's Test. Results Results: positive outcomes in all tested domains but no statistically significant difference between the groups. Promote early intervention. Conclusions The results showed statistically significant outcomes in both groups (p < .05), both in the decrease of Unilateral Spatial Neglect and overall function. Overall, the results indicated that early intervention of unilateral spatial neglect can result in functional gains as evidenced by medium-large effect size in Functional Independence Measure; motor (Hedges’ g=0.6) and cognitive domains (Hedges’=0.8). The results had no statistically significant difference between groups (p < 05). The computer graphics of the treatment group indicated a general deviation towards the unaffected side on initial assessment but more midline oriented on final assessment. Author(s) Disclosures This is to certify that the author was not affiliated with the manufacturers of InMotion2 Robot and had no financial gains in relation to this study. 1. Determining if the InMotion2 Robot can be useful in alleviating unilateral spatial neglect 2. To understand if deficits with theoretical relationship can be addressed at the same time during the intervention (Muscle activation and Unilateral Spatial Neglect) 3. To determine the effect of early intervention to alleviate unilateral spatial neglect. Quasi-Experimental design with test - posttest. Inpatient Rehabilitation. A sample of convenience through consecutive sampling was used for this study and setting. The sample was derived from patients admitted to the Rehabilitation Institute due to a new onset of stroke, and exhibiting signs of unilateral spatial neglect, as determined by Albert's test, Star Cancellation and Catherine Bergego's Scale. 23 met the inclusion criteria. 16 completed the study with five in Robotic (treatment) group and eleven in control group. Both groups received conventional therapy, but the Robotic (treatment) group also received an extra 30 minutes of robotic training for ten days within the first two weeks of rehabilitation. The conventional therapy entailed training in activities of daily living, muscle activation and midline orientation. Robotic treatment entailed computer games with targets acquired through the interactive movement of robot with visual feed back. Catherine Bergego's Scale, Functional Independence Measure, Star Cancellation, and Albert's Test. Results: positive outcomes in all tested domains but no statistically significant difference between the groups. Promote early intervention. The results showed statistically significant outcomes in both groups (p < .05), both in the decrease of Unilateral Spatial Neglect and overall function. Overall, the results indicated that early intervention of unilateral spatial neglect can result in functional gains as evidenced by medium-large effect size in Functional Independence Measure; motor (Hedges’ g=0.6) and cognitive domains (Hedges’=0.8). The results had no statistically significant difference between groups (p < 05). The computer graphics of the treatment group indicated a general deviation towards the unaffected side on initial assessment but more midline oriented on final assessment.

The effects of robot-assisted left-hand training on hemispatial neglect in older patients with chronic stroke: A pilot and randomized controlled trial.

Background:Even though a variety of rehabilitative technique have been implemented to ameliorate neglect symptoms of patients with stoke, the effects of limb activation using a robotic device are still unknown. The purpose of this study was to investigate the effects of the robot-assisted hand training on hemispatial neglect of older patients with chronic stroke.Methods:The participants were randomly allocated to the experimental group (EG) receiving robot-assisted left-hand training (n = 12) or the control group (CG) receiving conventional treatments for neglect symptoms (n = 12). All participants received 20 sessions for 4-week. To examine the effects on hemispatial neglect, the line bisection test (LBT), the Albert test, and the Catherine Bergego Scale (CBS) were utilized. The outcome measures were analyzed before and after the 20 training sessions.Results:After the intervention, improvements in the LBT, the Albert test, and the CBS were found in the EG whereas there were significant improvements in the LBT and the CBS but not the Albert test in the CG. In addition, the EG showed a significantly greater gain in all outcome measures compared to the CG (p < .05).Conclusions:These results indicate that robot-assisted hand training was beneficial to improving the hemispatial neglect of elderly person with chronic stroke compared to the conventional treatments. Robot-assisted limb activation might be useful to ameliorate hemispatial neglect of the elderly with chronic stroke.

The Effect of Prism Glasses on Reducing Unilateral Spatial Neglect

Purpose : The purpose of this study was to identify whether prism glasses could reduce unilateral spatial neglect for hemineglect with stroke. Methods : This study was conducted in M hospital located in Seoul from May 2019 to February 2020. Ten subjects with stroke were selected who met the criteria for the study. Subjects were prescribed with 10 and 15 △ prism glasses. Unilateral spatial neglect was measured by the Albert test, the star cancellation test and the letter cancellation test. Results : The baseline of Albert's test value was 19.0±3.94 and decreased to 15.70±5.68 and 11.60±6.17 for 10 and 15 △, respectively(p<0.050). The star cancellation test value increased from 32.68±9.19 to 46.07±10.64 and 54.64±12.91(p<0.050). The letter cancellation test value increased from 18.30±5.14 to 23.50±7.58 and 27.0±5.76(p<0.050). Prism adaptation treatment showed that unilateral spatial neglect decreased in all tests. Conclusion : The prism glasses showed that there was effect on the reduction of unilateral spatial neglect. It is, therefore, thought that theunilateral spatial neglect with stroke could decrease with prism glasses.

Current diagnosis and treatment of Duchenne muscular dystrophy

Duchenne muscular dystrophy (DMD) is an X-linked progressive disease from the group of primary myopathies caused by mutations in the DMD gene and a lack of dystrophin protein in the muscle fiber in males. The review considered the prevalence of pathology, the most common causes of dystrophinopathy, and the role of dystrophin not only in the functioning of muscles but also in the architectural organization of the Central nervous system. The disease classification based on stages and forms, initial clinical manifestations of the early and late stages of the disease, as well as neuropsychological, orthopedic, respiratory and cardiovascular disorders, are described in detail. The relevant to date diagnostic algorithm for suspected DMD, biochemical blood analysis, genetic, morphological (immunocytochemical staining of muscles with dystrophin antibodies) and instrumental (ultrasound, MRI) methods of examination are presented in detail. Particular attention in the diagnosis of DMD and objectification of disorders is given to assessment tests [Baileys and Griffiths scales, Albert's Test of Infant Posture and Motor Assessment Scale, Expanded Hammersmith Functional Motor Scale (HFMSE), the Gross Motor Function Measure (GMFM), and the 6-minute walk test (6MWT)]. The review presents the advantages and disadvantages of modern invasive and non-invasive diagnostic techniques of the disease, indicating their reliability and the possibility of application at early stages, including prenatal. In conclusion, the treatment of DMD and its most frequent complications, both widely used in practice and at the stage of clinical research, is highlighted. It was emphasized the importance of rehabilitation measures that improve the duration and quality of life of patients with DMD. The main task of analyzing available sources on the most pressing issues of Duchenne muscular dystrophy was to stimulate research and social activity in resolving unsolved problems today.

The Effect of a Complex Intervention Program for Unilateral Neglect in Patients with Acute-Phase Stroke: A Randomized Controlled Trial.

ObjectivesThe purpose of this study was to examine the combined effects of Prism Adaptation (PA) plus functional electrical stimulation (FES) on stroke patients with unilateral neglect, and suggest a new intervention method for acute-phase stroke patients.MethodsThere were 30 patients included in this study from April to October 2016 that had unilateral neglect whilst hospitalized following a stroke (diagnosed by a professional). The participants, who were patients receiving occupational therapy, understood the purpose of the study and agreed to participate. The patients were randomly divided into 3 groups: PA plus FES group (Group A), PA group (Group B), and FES group (Group C). Treatments lasted for 50 minutes per day, 5 times per week, for 3 weeks in total. Reevaluation was conducted after 3 weeks of intervention.ResultsAll 3 groups showed unilateral neglect reduction after the intervention, but PA plus FES (complex intervention method) was more effective than PA or FES alone [effect size: Motor-free Visual Perception Test (0.80), Albert test (0.98), CBS (0.92)].ConclusionThe results of this study support further studies to examine complex intervention for the treatment of unilateral neglect.

Noninvasive Brain Stimulations for Unilateral Spatial Neglect after Stroke: A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Controlled Trials.

Background Unilateral spatial neglect (USN) is the most frequent perceptual disorder after stroke. Noninvasive brain stimulation (NIBS) is a tool that has been used in the rehabilitation process to modify cortical excitability and improve perception and functional capacity. Objective To assess the impact of NIBS on USN after stroke. Methods An extensive search was conducted up to July 2016. Studies were selected if they were controlled and noncontrolled trials examining transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and theta burst stimulation (TBS) in USN after stroke, with outcomes measured by standardized USN and functional tests. Results Twelve RCTs (273 participants) and 4 non-RCTs (94 participants) proved eligible. We observed a benefit in overall USN measured by the line bisection test with NIBS in comparison to sham (SMD −2.35, 95% CI −3.72, −0.98; p = 0.0001); the rTMS yielded results that were consistent with the overall meta-analysis (SMD −2.82, 95% CI −3.66, −1.98; p = 0.09). The rTMS compared with sham also suggested a benefit in overall USN measured by Motor-Free Visual Perception Test at both 1 Hz (SMD 1.46, 95% CI 0.73, 2.20; p < 0.0001) and 10 Hz (SMD 1.19, 95% CI 0.48, 1.89; p = 0.54). There was also a benefit in overall USN measured by Albert's test and the line crossing test with 1 Hz rTMS compared to sham (SMD 2.04, 95% CI 1.14, 2.95; p < 0.0001). Conclusions The results suggest a benefit of NIBS on overall USN, and we conclude that rTMS is more efficacious compared to sham for USN after stroke.

The Effect of 1 Hz Repetitive Transcranial Magnetic Stimulation Combined with Task-oriented Training on Upper Limb Function and Hemineglect in Stroke Patients

The purpose of this study was to investigate the effect of rTMS on upper limb dysfunction and hemineglect patients after stroke and to find out the most effective application method. This study was conducted with 25 subjects who were diagnosed as a hemiparesis by stroke. Participants in the experimental (12 members) and control groups (13 members) received rTMS and sham rTMS during a 20 minutes session, five days per week for four weeks, respectively, followed by task-oriented training during a 30 minutes session. Motor recovery evaluation was performed by fugl meyer assessment (FMA), box and block test (BBT), albert test (AT) and grip strength test. The experimental group showed significant increments in FMA, BBT, AT, and grip strength test, compared to the pre-intervention results (p 〈 0.01). Furthermore, the control group showed significant increments in the FMA, BBT, AT, compared to the pre-intervention results (p 〈 0.05). A significant difference in the post-training gains in FMA, AT, and grip strength test were observed between the experimental group and the control group (p 〈0.05). In addition, the effect size for gains in the experimental and control groups was very strong in FMA, AT, grip strength test (effect size = 1.29, 1.45, 0.96 respectively) and the effect size for gains in the experimental and control groups was very weak in BBT (effect size = 0.20). The findings demonstrate that application of 1 Hz rTMS combined with task-oriented training can be helpful in improving upper limb function and hemineglect of stroke.

Recovery of Proprioception in the Upper Extremity by Robotic Mirror Therapy: a Clinical Pilot Study for Proof of Concept.

A novel robotic mirror therapy system was recently developed to provide proprioceptive stimulus to the hemiplegic arm during a mirror therapy. Validation of the robotic mirror therapy system was performed to confirm its synchronicity prior to the clinical study. The mean error angle range between the intact arm and the robot was 1.97 to 4.59 degrees. A 56-year-old male who had right middle cerebral artery infarction 11 months ago received the robotic mirror therapy for ten 30-minute sessions during 2 weeks. Clinical evaluation and functional magnetic resonance imaging (fMRI) studies were performed before and after the intervention. At the follow-up evaluation, the thumb finding test score improved from 2 to 1 for eye level and from 3 to 1 for overhead level. The Albert's test score on the left side improved from 6 to 11. Improvements were sustained at 2-month follow-up. The fMRI during the passive motion revealed a considerable increase in brain activity at the lower part of the right superior parietal lobule, suggesting the possibility of proprioception enhancement. The robotic mirror therapy system may serve as a useful treatment method for patients with supratentorial stroke to facilitate recovery of proprioceptive deficit and hemineglect.

The Effect of an Upper Limb Rehabilitation Robot on Hemispatial Neglect in Stroke Patients.

ObjectiveTo investigate the effectiveness of an upper limb rehabilitation robot therapy on hemispatial neglect in stroke patients.MethodsPatients were randomly divided into an upper limb rehabilitation robot treatment group (robot group) and a control group. The patients in the robot group received left upper limb training using an upper limb rehabilitation robot. The patients sat on the right side of the robot, so that the monitor of the robot was located on the patients' left side. In this position, patients could focus continuously on the left side. The control group received conventional neglect treatment, such as visual scanning training and range of motion exercises, administered by occupational therapists. Both groups received their respective therapies for 30 minutes a day, 5 days a week for 3 weeks. Several tests were used to evaluate treatment effects before and after the 3-week treatment.ResultsIn total, 38 patients (20 in the robot group and 18 in the control group) completed the study. After completion of the treatment sessions, both groups showed significant improvements in the Motor-Free Visual Perception Test 3rd edition (MVPT-3), the line bisection test, the star cancellation test, the Albert's test, the Catherine Bergego scale, the Mini-Mental State Examination and the Korean version of Modified Barthel Index. The changes in all measurements showed no significant differences between the two groups.ConclusionThis present study showed that the upper limb robot treatment had benefits for hemispatial neglect in stroke patients that were similar to conventional neglect treatment. The upper limb robot treatment could be a therapeutic option in the treatment of hemispatial neglect after stroke.

The effects of repetitive transcranial magnetic stimulation on unilateral neglect of acute stroke patients: A randomised controlled trial.

Rehabilitation of the unilateral neglect of acute stroke patients represents a major challenge. This study aimed to evaluate the effects of repetitive transcranial magnetic stimulation on the functional recovery of stroke patients with unilateral neglect. Twenty patients with stroke were randomly assigned to two groups: a repetitive transcranial magnetic stimulation group (experimental) and a control group. The stroke patients in the experimental group underwent repetitive transcranial magnetic stimulation therapy and comprehensive rehabilitation therapy. The stroke patients in the control group underwent sham magnetic stimulation therapy and comprehensive rehabilitation therapy. The patients in both groups received therapy 5 days per week for 4 weeks. The Motor Free Visual Perception Test (MVPT), Line Bisection Test (LBT), Albert Test (AT), and Star Cancellation Test (SCT) were assessed before and after the 4-week therapy period. The experimental group showed a significant increase in the MVPT, LBT, AT, and SCT values compared with the preintervention values (p < 0.05). Furthermore, the control group showed a significant increase in the MVPT, LBT, and AT results compared with the preintervention results (p < 0.05). A significant difference in the post-training gains for the MVPT (8.9 ± 2.5 vs. 4.8 ± 3.0), LBT (-19.3 ± 7.5 vs. -6.5 ± 9.5), AT (13.1 ± 8.0 vs. 4.0 ± 1.9), and SCT (-13.6 ± 6.9 vs. -4.5 ± 6.9) were observed between the experimental group and the control group (p < 0.05). In addition, the effect size for gains in the experimental and control groups was very large in MVPT and AT (effect size = 3.25 and 2.90), respectively, and the effect size for gains in the experimental and control groups was small in LBT and SCT (effect size = 0.22 and 0.23, respectively). The current study findings indicated that repetitive transcranial magnetic stimulation may be beneficial in decreasing the unilateral neglect of stroke patients.

Risk Factor of Visuospatial Neglect: A Study of Association Between Visuospatial Neglect and Anemia

ObjectiveTo investigate the correlation between visuospatial neglect and anemia in patients with right cerebral infarction, as well as to identify the risk factor of neglect and furnish preliminary data on rehabilitation management.MethodsThe line bisection test and Albert test were conducted on subjects with right cerebral infarction in order to analyze neglect severity. Multiple linear regression analysis was conducted to investigate correlation between neglect severity and hemoglobin and hematocrit level. Logistic regression analysis was applied to identify the risk factor of neglect.ResultsVisuospatial neglect was observed in 33 subjects out of 124. Hemoglobin and hematocrit were not directly correlated with visuospatial neglect severity, whereas infarct size was directly correlated. Subjects with visuospatial neglect were characterized by a large infarct size, a low score in the Mini-Mental State Examination and long hospital stay.ConclusionIn this study, visuospatial neglect was found to be uncorrelated with anemia. It implies that emphasis should be placed on the early detection of anemia and neglect in patients with left hemiplegia, the formulation of respective therapeutic plans and improvement of prognosis. The study found that the possibility of a visuospatial neglect occurrence increases with infarct size. In this regard, it is required that visuospatial neglect was detected and treated in the earliest possible stage, notwithstanding the difficulty that lies in the precise measurement of the severity.

Repetitive transcranial magnetic stimulation to hemispatial neglect in patients after stroke: An open-label pilot study

To test whether multiple sessions of inhibitory low-frequency repetitive transcranial magnetic stimulation (rTMS) applied to the left parietal area can improve hemispatial neglect after stroke. An open-label design. Seven consecutive patients with hemispatial neglect after right hemispheric stroke were compared with 7 retrospectively recruited control patients. Seven patients received a session of 1 Hz rTMS to the left parietal area immediately prior to occupational therapy for 10 days. Seven control patients received only behavioural therapy. Baseline values of the line bisection test and the Albert test were comparable in the two groups. The stimulation group showed a greater improvement in the line bisection test than did the control group. However, no differences were found between the two groups according to the Albert test. In this pilot study, low-frequency rTMS application to the non-affected left parietal area was found to be safe and to improve line bisection test, which suggests that non-invasive cortical stimulation has a potential role as an adjuvant strategy during cognitive rehabilitation training in patients with hemispatial neglect. A prospective randomized, sham-controlled study is required to determine the beneficial role of non-invasive cortical stimulation on hemispatial neglect.

The Neural Basis of Body Form and Body Action Agnosia

Visual analysis of faces and nonfacial body stimuli brings about neural activity in different cortical areas. Moreover, processing body form and body action relies on distinct neural substrates. Although brain lesion studies show specific face processing deficits, neuropsychological evidence for defective recognition of nonfacial body parts is lacking. By combining psychophysics studies with lesion-mapping techniques, we found that lesions of ventromedial, occipitotemporal areas induce face and body recognition deficits while lesions involving extrastriate body area seem causatively associated with impaired recognition of body but not of face and object stimuli. We also found that body form and body action recognition deficits can be double dissociated and are causatively associated with lesions to extrastriate body area and ventral premotor cortex, respectively. Our study reports two category-specific visual deficits, called body form and body action agnosia, and highlights their neural underpinnings.

Mirror Approach for the Patients with Unilateral Spatial Neglect and Mirror Agnosia

Mirror Agnosia is characterized by searching for the mirror image and showing difficulty of modifying behavior even after the object is presented in real space (Ramachandran, 1997). The possibility of therapeutic intervention of using a mirror for unilateral spatial neglect (USN) with mirror agnosia was suggested, but few researches on mirror agnosia and mirror approach for USN have been reported. The purpose of this study was to confirm the influence of the use of a mirror for USN with mirror agnosia. Two patients with left hemiparesis with USN were evaluated. We propped a mirror on the right side of the patient parallel to the sagittal plane and presented a ball apart from it. We asked the patient to grasp it with looking into the mirror. If they could not reach the actual ball, we shifted the ball closer to the mirror and tried again. When two patients grasped the ball, we asked them to reach it repeatedly. Albert test was executed before and after the session. Both patients could not reach the ball initially, but were able to grasp it when it was closer to the mirror. They showed an improvement in the Albert test after this approach. This method might be useful therapeutic intervention for USN with mirror agnosia.

Use of the ‘STRATIFY’ falls risk assessment in patients recovering from acute stroke

To investigate the predictive validity and reliability of the STRATIFY falls risk assessment tool as applied to patients recovering from acute stroke. Prospective cohort study. Six stroke rehabilitation units in the North of England. All patients with a diagnosis of acute stroke admitted to the participating stroke units during a 6-month study period. on admission, falls risk (STRATIFY), disability (Barthel index), mobility (Rivermead mobility index), cognitive impairment (abbreviated mental test score) and visual neglect (Albert's test) were assessed. Then, STRATIFY was completed weekly and within 48 h of anticipated discharge. Consenting patients were contacted at 3 months after discharge to determine falls. Occurrence of a fall within 28 days of the baseline STRATIFY (in-patient study), falls in the first 3 months after discharge (post-discharge study) and falls during stroke unit stay (reliability study). From 387 patients admitted to the participating units during the study period, 225 contributed to the 28 day in-patient study, and 234 were followed up at 3 months after discharge. STRATIFY performed poorly in predicting falls in the first 28 days (sensitivity 11.3% and specificity 89.5%) and after discharge (sensitivity 16.3% and specificity 86.4%). Agreement was 'fair' between baseline and discharge scores (kappa = 0.263) and 'good' between the pre-hospital discharge score and that obtained in the week preceding discharge (kappa = 0.639). STRATIFY performed poorly as a predictor of falls in a heterogeneous population of stroke patients. There is a need for a disease-specific rather than a generic falls risk assessment tool.

Unilateral neglect and perceptual parsing: a large-group study

Array-centred and subarray-centred neglect were disambiguated in a group of 116 patients with left neglect by means of a modified version of the Albert test in which the central column of segments was deleted so as to create two separate sets of targets grouped by proximity. The results indicated that neglect was more frequent in array- than subarray-centred coordinates and that, in a minority of cases, neglect co-occurred in both coordinate-systems. The two types of neglect were functionally but not anatomically dissociated. Presence of visual field defects was not prevalent in one type of neglect with respect to the other. These data contribute further evidence to previous single-case and small-group studies by showing that neglect can occur in single or multiple reference frames simultaneously, in agreement with current neuropsychological, neurophysiological and computational concepts of space representation.