Neglect In Stroke Patients Research Articles

Effects of Twins Therapy on Egocentric and Allocentric Neglect in Stroke Patients: A Feasibility Study.

(1) Background: Existing treatment methods for neglect are concentrated on egocentric neglect and may lead to various problems such as cost/space constraints and portability. Therefore, this study seeks to determine how a new treatment (also known as twins therapy, TT) for stroke patients can improve an existing problem associated with neglect. (2) Method: A pre/post-test control group research design was used and both groups continued to receive existing rehabilitation treatment, whilst TT intervention was only added to the experimental group. TT intervention was conducted for a total of 20 sessions (1 session for 30 min/day, 5 days/week, for 4 weeks). (3) Result: There was no significant difference in the manual function test (MFT) and the Korean version of the Modified Barthel Index (K-MBI) items (p > 0.05) before and after the TT intervention. However, the score and execution time of the apple cancellation test showed a significant reduction only in the experimental group (p < 0.05). (4) Conclusion: TT not only improved egocentric neglect, but also allocentric neglect symptoms in stroke patients.

Prostorový neglekt u pacientů po cévní mozkové příhodě

Prostorový neglekt (PN) je heterogenní syndrom, který se vyskytuje u jedinců po získaném poškození mozku. Jedná se o poruchu prostorové pozornosti, která má negativní dopad na funkční stav jedince, jeho soběstačnost, psychosociální schopnosti a též negativně ovlivňuje rehabilitační výstupy.V rámci logopedické intervence se PN nejvíce se projevuje během čtení a psaní. PN se může vyskytovat v různých variantách a z tohoto důvodu je nutné provádět dostatečnou a vhodnou diagnostiku. Volba diagnostických nástrojů může být klíčová pro odhalení typu neglektu a následné nastavení terapeutických technik, přístupů a vlastní léčby neglektu. Nejčastěji užívané diagnostické nástroje jsou ve formě &#8222;tužka&#8211;papír&#8220;, které však nemají dostatečnou senzitivitu a neodhalí různé varianty PN s ohledem na funkční stav jedince.I přes široké množství popsaných metod k léčbě PN doposud neexistuje v odborné společnosti jednoznačný konsensus ohledně léčby PN. Často užívanou metodou je optokinetická stimulace. V posledních letech se však do popředí dostává léčba PN pomocí prizmatické adaptace, která využívá efektu laterálního posouvání zrakového pole pomocí prizmatických čoček.

Comparing the effectiveness of bimanual and unimanual mirror therapy in unilateral neglect after stroke: A pilot study.

Unilateral neglect in stroke patients is a major obstacle to rehabilitation, which is a great challenge for therapists. This study aimed to compare the effectiveness of bimanual mirror therapy (BMT) and unimanual mirror therapy (UMT), the two protocols of mirror therapy, for the reduction of the symptoms of unilateral neglect in stroke patients. Twenty-eight individuals were randomly assigned to the BMT or UMT groups. Both groups received mirror therapy for 30 minutes per day, 5 days a week, for a period of 4 weeks. The Star Cancelation Test (SCT), Line Bisection Test (LBT), Picture Scanning Test (PST), and Korean Catherine Bergego Scale (K-CBS) were used to measure the change in unilateral neglect, and the Korean version of the Modified Barthel Index (K-MBI) was used to evaluate activities of daily living (ADL). The results of SCT, LBT, PST, and K-CBS showed significant decreases in unilateral neglect in both groups (p < 0.05). K-MBI improved significantly in both groups (p < 0.05). There were significant differences between the two groups in the unilateral neglect tests (p < 0.05), but no significant difference in ADL evaluation (p > 0.05). Mirror therapy protocols can be applied to treat unilateral neglect in stroke patients. However, BMT may be more beneficial for reducing the symptoms of unilateral neglect.

Theta-burst transcranial magnetic stimulation for the treatment of unilateral neglect in stroke patients: A systematic review and best evidence synthesis.

Background:Unilateral neglect (UN) is a common and disabling disorder after stroke. UN is a strong and negative predictor of functional rehabilitative outcome. Non-invasive brain stimulation, such as theta-burst transcranial magnetic stimulation (TBS), is a promising rehabilitation technique for treating stroke-induced UN.Objective:To systematically review the available literature, researching whether TBS of the contra-lesional hemisphere is more effective than standard rehabilitation in improving symptoms of UN in patients with right hemisphere stroke.Review methods:A systematic review was conducted to retrieve randomized controlled trials (RCTs) that were relevant to the objective of this review. PubMed, Ovid and Cochrane Library electronic databases were comprehensively searched from inception up to February 2021. Of the included studies, methodological quality was assessed using the PEDro scale, whereafter a best evidence synthesis (BES) was conducted to summarize the results.Results:Nine RCTs investigating the effects of TBS on stroke-induced UN symptoms were included in this review. Seven studies assessing continuous TBS (cTBS) found significantly greater amelioration of UN symptoms in the TBS intervention group when compared to the control group; one study assessing cTBS found no such significant difference. One study assessing intermittent TBS (iTBS) found significant between-group differences in favor of the intervention. The BES yielded strong evidence in favor of cTBS, and limited evidence in favor of iTBS.Conclusions:The included studies in the present review allow the conclusion that TBS can have favorable effects on UN recovery in stroke patients. Its clinical use is recommended in conjunction with cognitive rehabilitation and occupational or physical rehabilitation as needed. However, many aspects for optimal usage of TBS therapy in clinical settings, such as exact TBS protocols, number of sessions, and treatment duration, are not clear.

Spatial Neglect Midline Diagnostics From Virtual Reality and Eye Tracking in a Free-Viewing Environment.

Purpose: Virtual reality (VR) and eye tracking may provide detailed insights into spatial cognition. We hypothesized that virtual reality and eye tracking may be used to assess sub-types of spatial neglect in stroke patients not readily available from conventional assessments.Method: Eighteen stroke patients with spatial neglect and 16 age and gender matched healthy subjects wearing VR headsets were asked to look around freely in a symmetric 3D museum scene with three pictures. Asymmetry of performance was analyzed to reveal group-level differences and possible neglect sub-types on an individual level.Results: Four out of six VR and eye tracking measures revealed significant differences between patients and controls in this free-viewing task. Gaze-asymmetry between-pictures (including fixation time and count) and head orientation were most sensitive to spatial neglect behavior on a group level analysis. Gaze-asymmetry and head orientation each identified 10 out of 18 (56%), compared to 12 out of 18 (67%) for the best conventional test. Two neglect patients without deviant performance on conventional measures were captured by the VR and eyetracking measures. On the individual level, five stroke patients revealed deviant gaze-asymmetry within-pictures and six patients revealed deviant eye orientation in either direction that were not captured by the group-level analysis.Conclusion: This study is a first step in using VR in combination with eye tracking measures as individual differential neglect subtype diagnostics. This may pave the way for more sensitive and elaborate sub-type diagnostics of spatial neglect that may respond differently to various treatment approaches.

EEG-based Neglect Detection for Stroke Patients.

Spatial neglect (SN) is a neurological syndrome in stroke patients, commonly due to unilateral brain injury. It results in inattention to stimuli in the contralesional visual field. The current gold standard for SN assessment is the behavioral inattention test (BIT). BIT includes a series of penand-paper tests. These tests can be unreliable due to high variablility in subtest performances; they are limited in their ability to measure the extent of neglect, and they do not assess the patients in a realistic and dynamic environment. In this paper, we present an electroencephalography (EEG)-based brain-computer interface (BCI) that utilizes the Starry Night Test to overcome the limitations of the traditional SN assessment tests. Our overall goal with the implementation of this EEG-based Starry Night neglect detection system is to provide a more detailed assessment of SN. Specifically, to detect the presence of SN and its severity. To achieve this goal, as an initial step, we utilize a convolutional neural network (CNN) based model to analyze EEG data and accordingly propose a neglect detection method to distinguish between stroke patients without neglect and stroke patients with neglect.Clinical relevance-The proposed EEG-based BCI can be used to detect neglect in stroke patients with high accuracy, specificity and sensitivity. Further research will additionally allow for an estimation of a patient's field of view (FOV) for more detailed assessment of neglect.

Immersive 3D Virtual Reality Cancellation Task for Visual Neglect Assessment: A Pilot Study.

Background: Unilateral spatial neglectis an attention disorder frequently occurring after a right-hemispheric stroke. Neglect results in a reduction in qualityof life and performance in activities of daily living. With current technical improvements in virtual reality (VR) technology, trainingwith stereoscopic head-mounted displays (HMD) has become a promising new approach for the assessment and the rehabilitation of neglect. The focus of this pilot study was to develop and evaluate a simple visual search task in VR for HMD. The VR system was tested regarding feasibility, acceptance, and potential adverse effects in healthy controls and right-hemispheric stroke patients with and without neglect.Methods: The VR system consisted of two main components, a head-mounted display to present the virtual environment, and a hand-held controller for the interaction with the latter. The task followed the rationale of diagnostic paper-pencil cancellation tasks; i.e., the participants were asked to search targets among distractors. However, instead of a two-dimensional setup, the targets and distractors were arranged in three dimensions, in a sphere around the subject inside its field of view. Usability and acceptance of the task, as well as the performance in the latter, were tested in 15 right-hemispheric subacute stroke patients (10 of whom with and five of whom without unilateral spatial neglect; mean age: 67.1 ± 10.5 years) and 35 age-matched healthy controls.Results: System usability and acceptance were rated as high both in stroke patients and healthy controls, close to the maximum score of the questionnaire scale. No relevant adverse effects occurred. There was a high correlation (r = 0.854, p = 0.002) between the Center of Cancellation [an objective neglect measure) calculated from a paper-pencil cancellation task (Sensitive Neglect Test (SNT)] and the newly developed VR cancellation task.Conclusion: Overall, the developed visual search task in the tested VR system is feasible, well-accepted, enjoyable, and does not evoke any significant negative effects, both for healthy controls and for stroke patients. Findings for task performance show that the ability of the VR cancellation to detect neglect in stroke patients is similar to paper-pencil cancellation tasks.

Zhishen Tiaosui acupuncture on the unilateral spatial neglect after stroke: a randomized controlled trial

To evaluate the clinical curative effect of Zhishen Tiaosui acupuncture on unilateral spatial neglect (USN) after stroke. Sixty-four patients with left hemiplegia after the first stroke and diagnosed with unilateral spatial neglect after stroke in the right hemisphere were randomly divided into an observation group and a control group, 32 cases in each group. In the control group, conventional acupuncture was used at Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), Waiguan (TE 5), Hegu (LI 4), Huantiao (GB 30), Yanglingquan (GB 34), Zusanli (ST 36) and Sanyinjiao (SP 6) on the affected side. In the observation group, Zhishen Tiaosui acupuncture was applied at Baihui (GV 20), Fengfu (GV 16), Fengchi (GB 20), Xuanzhong (GB 39) and Niesanzhen. The treatment was given once a day, 5 times as one course for 4 courses in both groups. The cancellation test, digit cancellation test, bisection line test, clock drawing test, and copying drawing test were used to assess the degree of unilateral spatial neglect, and the Fugl-Meyer motor function scores and the modified Barthel index (MBI) scores were compared before and after treatment in the two groups. After treatment, the scores of cancellation test, digit cancellation test, bisection line test, clock drawing test and copying drawing test were significantly lower than those before treatment in the two groups (all P<0.05), and the scores of the above unilateral spatial neglect after treatment in the observation group were lower than those in the control group (all P<0.01). After treatment, the scores of Fugl-Meyer motor function and MBI in the two groups were significantly higher than before treatment (all P<0.05), and the difference of MBI scores before and after treatment in the observation group was higher than that in the control group (P<0.01). Zhishen Tiaosui acupuncture can improve the cognition of unilateral spatial neglect in stroke patients with unilateral spatial neglect, improve the degree of bilateral spatial neglect and the motor function of hemiplegic limbs, and positively promote the improvement of cognitive impairment and self-care ability in daily life.

Allocentric Versus Egocentric Neglect in Stroke Patients: A Pilot Study Investigating the Assessment of Neglect Subtypes and Their Impacts on Functional Outcome Using Eye Tracking.

Few studies have investigated the assessment and functional impact of egocentric and allocentric neglect among stroke patients. This pilot study aimed to determine (1) whether allocentric and egocentric neglect could be dissociated among a sample of stroke patients using eye tracking; (2) the specific patterns of attention associated with each subtype; and (3) the nature of the relationship between neglect subtype and functional outcome. Twenty acute stroke patients were administered neuropsychological assessment batteries, a pencil-and-paper Apples Test to measure neglect subtype, and an adaptation of the Apples Test with an eye tracking measure. To test clinical discriminability, twenty age- and education-matched control participants were administered the eye tracking measure of neglect. The eye tracking measure identified a greater number of individuals as having egocentric and/or allocentric neglect than the pencil-and-paper Apples Test. Classification of neglect subtype based on eye tracking performance was a significant predictor of functional outcome beyond that accounted for by the neuropsychological test performance and Apples Test neglect classification. Preliminary evidence suggests that patients with no neglect symptoms had superior functional outcomes compared with patients with neglect. Patients with combined egocentric and allocentric neglect had poorer functional outcomes than those with either subtype. Functional outcomes of patients with either allocentric or egocentric neglect did not differ significantly. The applications of our findings, to improve neglect detection, are discussed. Results highlight the potential clinical utility of eye tracking for the assessment and identification of neglect subtype among stroke patients to predict functional outcomes. (JINS, 2019, 25, 479-489).

The Effects of Task Application after Hand Intrinsic Muscle Treatment on Decreasing Unilateral Spatial Neglect in Stroke Patients

Background/Objectives: In this study, we assessed the effects of task application after hand intrinsic muscle treatment on decreasing unilateral spatial neglect in stroke patients.Method/Statistical Analysis: 20 subjects with stroke patients participated. Subjects were randomly divided into task application after hand intrinsic muscle treatment group (n=10) and common upper extremity task group (n=10) both therapy was applied for 30mins in a day and 5 times in a week for 2 weeks. The Albert’s test, Line bisection test was used to evaluate unilateral spatial neglect by paretic side(left) in stroke patients. To compare the treatments, we used paired t-test and independent sample t-test.Findings: The task application after hand intrinsic muscle treatment group and common upper extremity task group showed statically significant differences before and after unilateral spatial neglect. The experimental group showed a more significant difference compared with the control group when Albert’s test, Line bisection test.Improvements/Applications: The task application after hand intrinsic muscle treatment was more effective in unilateral spatial neglect of stroke patients than in reaching treatment.

The Effects of Task Application after Hand Intrinsic Muscle Treatment on Decreasing Unilateral Spatial Neglect in Stroke Patients

Background/Objectives: In this study, we assessed the effects of task application after hand intrinsic muscle treatment on decreasing unilateral spatial neglect in stroke patients.Method/Statistical Analysis: 20 subjects with stroke patients participated. Subjects were randomly divided into task application after hand intrinsic muscle treatment group (n=10) and common upper extremity task group (n=10) both therapy was applied for 30mins in a day and 5 times in a week for 2 weeks. The Albert’s test, Line bisection test was used to evaluate unilateral spatial neglect by paretic side(left) in stroke patients. To compare the treatments, we used paired t-test and independent sample t-test.Findings: The task application after hand intrinsic muscle treatment group and common upper extremity task group showed statically significant differences before and after unilateral spatial neglect. The experimental group showed a more significant difference compared with the control group when Albert’s test, Line bisection test.Improvements/Applications: The task application after hand intrinsic muscle treatment was more effective in unilateral spatial neglect of stroke patients than in reaching treatment.

Effect of Combined Therapy of Robot and Low-Frequency Repetitive Transcranial Magnetic Stimulation on Hemispatial Neglect in Stroke Patients.

ObjectiveTo investigate the effect of upper limb rehabilitation combining robot with low-frequency repetitive transcranial magnetic stimulation (rTMS) on unilateral spatial neglect in stroke patients.MethodsPatients who had hemispatial neglect after right hemisphere stroke were randomly divided into rTMS only group, robot only group, and combined group. All groups received conventional neglect therapy and additional treatment for each group. rTMS group received rTMS therapy. Robot group received robot therapy, while combined group received both therapies. The effect of therapy was assessed with Motor-Free Visual Perception Test-3 (MVPT-3), line bisection test, star cancellation test, Catherine Bergego Scale (CBS), Mini-Mental State Examination (MMSE), and the Korean version of Modified Barthel Index (K-MBI). These measurements were evaluated before and after treatment.ResultsFor each group, 10 patients were recruited. There were no significant differences in baseline characteristics or initial values among the three groups. Two weeks after the therapy, all groups showed significant improvement in MVPT-3, line bisection test, star cancellation test, CBS, MMSE, and K-MBI. However, changes in measurements showed no significant differences among groups.ConclusionTreatment effect of the combined therapy of robotic therapy and low-frequency rTMS therapy for hemispatial neglect was not statistically different from that of each single treatment. Resultsof this study did not prove the superiority of any of the three treatments. Further study with large number of patients is needed to evaluate the superiority of these treatments.

Adaptive Cueing Treatment of Neglect in Stroke Patients Leads to Improvements in Activities of Daily Living: A Randomized Controlled, Crossover Trial

Background. Visuospatial neglect is a disabling syndrome with serious consequences for activities in daily life. This study investigated the effect of adaptive cueing during a reading task as a possible treatment for neglect by including (1) a task relevant for the patient’s daily life, (2) a fading out procedure to stimulate independent orientation to the left by self-cueing, and (3) a clear definition of neglect severity for the adaptive treatment protocol. Methods. A randomized controlled crossover design was used, including 26 patients from an early rehabilitation unit with left-sided visuospatial neglect after stroke or hemorrhage. They were examined twice at baseline (T1, T2), after 15 daily sessions in 1 condition (T3), and again after 15 daily sessions in the other condition (T4). The intervention condition included a daily reading task combined with endogenous and exogenous cues provided by a therapist, which were continuously reduced after a patient had reached a defined level of performance. The control condition consisted of a neuropsychological treatment of the same length, not targeting visuospatial attention. Results. Significant improvements were shown after intervention on scores for reading (word and text reading), daily life activities (Catherine Bergego Scale), Line Bisection, and the Clock Drawing Task. Conclusion. This study shows that adaptive cueing in a reading task can improve neglect symptoms by using an intensive intervention lasting 3 weeks.

Contralesional Trunk Rotation Dissociates Real vs. Pseudo-Visual Field Defects due to Visual Neglect in Stroke Patients.

In stroke patients, the clinical presentation of visual field defects (VFDs) is frequently accompanied by visual neglect, i.e., the inability to attend and respond to the contralesional space. However, the diagnostic discrimination between the lack of reactions to contralesional stimuli due to VFDs or visual neglect is challenging during clinical examination. This discrimination is particularly relevant, since both clinical pictures are associated with different therapeutic approaches and outcomes. The aim of this study was to systematically investigate the effectiveness of trunk rotation toward the contralesional side—a manipulation dissociating the coordinate system of the trunk from that of the head and eyes—in disentangling real VFDs from “pseudo-VFDs” that occur due to visual neglect. Twenty patients with a left-sided VFD after a right-hemispheric stroke (10 additionally showing visual neglect in neuropsychological testing, VFD + neglect; 10 without neglect, VFD) were tested with Goldmann perimetry in both standard and trunk rotation conditions. In the standard condition, both VFD and VFD + neglect patients showed a conspicuous narrowing of the left visual field. However, trunk rotation triggered strikingly different patterns of change in the two groups: it elicited a significant increase in visual field extension in the VFD + neglect group, but left visual field extension virtually unchanged in the VFD group. Our results highlight contralesional trunk rotation as a simple, viable manipulation to effectively and rapidly disentangle real VFDs from “pseudo-VFDs” (i.e., due to visual neglect) during clinical examination.

Spatial neglect in stroke patients after discharge from rehabilitation to own home: a mixed method study

Purpose: To explore the usefulness of conventional tests for assessing spatial neglect and contrast these tests with daily challenges encountered by patients after discharge from rehabilitation to home.Methods: A mixed method prospective study of 15 patients with neglect after a right hemisphere stroke, <1 month after discharge to home. Data were obtained from: (1) Catherine Bergego Scale (CBS), (2) star cancellation and figure copying and (3) observations and interviews. Qualitative data were analysed with content analysis and quantitative data with non-parametric statistics. The data were presented in a ‘mixing matrix’ and integrated by ‘following threads’. Finally, a synthesis was written into a vignette.Results: The CBS significantly underestimated fluctuations and did not capture important items of neglect. The star cancellation and figure copying did not identify neglect in mildly affected participants. Left starting point in the star cancellation and a characteristic process of drawing in figure copying were observed in all participants.Conclusion: Traditional numerical interpretations of paper-pencil tests inadequately confirmed mild neglect. Starting points of the star cancellation and observation of drawing should be incorporated into screening procedures. Assessment strategies need improvement to identify patients with subtle forms of neglect.Implications for RehabilitationFindings demonstrate that identification of spatial neglect and the way symptoms of neglect impact on daily life functioning of stroke patients must be carefully pursued by health-care professionals working in stroke rehabilitation.Areas that should receive professional attention in the rehabilitation process include: preparing patients and their family for fluctuations related to neglect in the patient’s own home, locating issues that might impact safety, and identifying unique factors that either enhance or diminish neglect within each patient’s daily life context.The results of this study could be used to develop more wide-ranging assessment strategies to assist health-care professionals in identifying neglect after hospital discharge, for instance by expanding existing ecological assessment tools and including qualitative evaluation of test performance in paper-pencil tests, such as the star cancellation and figure copying.

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.

Propensity-matched analysis of the gap between capacity and actual performance of dressing in patients with stroke.

[Purpose] Dressing is an activity of daily living for which stroke patients often show discrepancies between capacity and actual performance. The aim of this study was to elucidate the physical function and unilateral spatial neglect in stroke patients that reduce their level of actual performance despite having the capacity for dressing independently. [Subjects and Methods] This retrospective study included 60 first-time stroke patients judged by occupational therapists as able to dress independently. The patients were divided into two groups according to their FIM® instrument scores for dressing the upper and lower body: an independent group with both scores ≥6 and an assistance group with one or both scores ≤5. After adjusting for confounding factors through propensity score matching, the groups were compared by using Stroke Impairment Assessment Set items, the Simple Test for Evaluating Hand Function of both upper limbs, and the Berg balance scale. [Results] The assistance group had a significantly lower score for the Berg balance scale than the independent dressing group (31.0 ± 12.3 vs. 47.8 ± 7.4). [Conclusion] The results of the present study suggested that the balance function has an effect on the discrepancy between dressing capacity and performance.

Treatment response profiles: An extension of the double dissociation concept in neuropsychological research

The presence of double dissociations in patients with neurological damage has long been used as evidence that the dissociated functions cannot be explained in terms of a common system or module. Shallice (1988) has suggested that a second procedure, the double critical variable method, can provide evidence for a similar conclusion. In this paper we examine the situation where double dissocations are not naturally present, suggesting that the two phenomena are merely aspects of the same underlying condition. We propose that the logic of the double critical variable method can be applied in this situation, whenever responses to treatment vary in a particular manner across syndromes and patients. This logic was previously used by Beschin, Cocchini, Allen, and Della Sala (2012) to show a dissociation between anosognosia and neglect in stroke patients; we suggest that it might have a more general application. As an aid in understanding the concept we also introduce the performance/performance curve; this builds on the existing idea of performance/resource curves to draw a single graph from two such curves, whose points may be derived from direct observation. It enables the empirical testing of hypotheses about the functional form of unobservable performance/resource relationships, and may be of use beyond the existing application to treatment response profiles.

Neglect and Motion Stimuli--Insights from a Touchscreen-Based Cancellation Task.

Background and PurposeIn stroke patients, neglect diagnostic is often performed by means of paper-pencil cancellation tasks. These tasks entail static stimuli, and provide no information concerning possible changes in the severity of neglect symptoms when patients are confronted with motion. We therefore aimed to directly contrast the cancellation behaviour of neglect patients under static and dynamic conditions. Since visual field deficits often occur in neglect patients, we analysed whether the integrity of the optic radiation would influence cancellation behaviour.MethodsTwenty-five patients with left spatial neglect after right-hemispheric stroke were tested with a touchscreen cancellation task, once when the evenly distributed targets were stationary, and once when the identic targets moved with constant speed on a random path. The integrity of the right optic radiation was analysed by means of a hodologic probabilistic approach.ResultsMotion influenced the cancellation behaviour of neglect patients, and the direction of this influence (i.e., an increase or decrease of neglect severity) was modulated by the integrity of the right optic radiation. In patients with an intact optic radiation, the severity of neglect significantly decreased in the dynamic condition. Conversely, in patients with damage to the optic radiation, the severity of neglect significantly increased in the dynamic condition.ConclusionMotion may influence neglect in stroke patients. The integrity of the optic radiation may be a predictor of whether motion increases or decreases the severity of neglect symptoms.

뇌졸중 환자의 편측무시 평가를 위한 한국형 캐서린 버지고 척도(K-CBS)의 신뢰도와 타당도 연구

뇌졸중 환자의 편측무시 평가를 위한 한국형 캐서린 버지고 척도(K-CBS)의 신뢰도와 타당도 연구