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ABSTRACT. The Catherine Bergego Scale (CBS) is a scale to evaluates the impact of unilateral spatial neglect (USN) on everyday life of patients after stroke. Objective: The aim of this study was to evaluate the reliability and comprehension of the Portuguese version of the CBS for patients with USN after stroke. Methods: This was a cross-sectional study in patients with stroke and USN. The CBS was translated, culturally adapted and applied by two independent investigators. The patients were also evaluated by the Behavioural Inattention Test (BIT), NIHSS, mRS and Barthel scale to assess USN severity, neurological function, disability and autonomy consecutively. Consistency and coherence were analysed using Cronbach’s α, inter-observer reliability by Kappa, and the correlation between the CBS, BIT, NIHSS, mRS, and Barthel was determined using Pearson correlation. Results: Twenty-two patients were evaluated and the observed Cronbach’s α=0.913. For intra-observer reproducibility, the 10 items showed a reasonable and high reliability between evaluators. The CBS showed a negative correlation with the BIT. There was a low correlation between the BIT and NIHSS, mRS and Barthel index. Conclusion: The CBS is an adequate and validated scale for assessing patients with USN after stroke in a Brazilian population.

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Introduction: The presence of microembolic signals (MES) during the acute phase of stroke is poorly understood, and its role and clinical application in relation to risk stratification and prognosis in patients remain uncertain. We assessed the prevalence of spontaneous MES in acute stroke and their relationship with risk stratification, stroke recurrence, morbidity, and mortality. Patients and methods:This was a prospective cohort study conducted in the Stroke Unit. The MES presence was evaluated by transcranial Doppler (TCD) in patients with ischemic stroke within 48 h. The outcomes (risk stratification, morbidity, mortality, and recurrence of a stroke) were followed up for 6 months. The relationship between risk stratification and MES was obtained by odds ratios and that between MES and stroke recurrence, morbidity, and mortality using multiple logistic regression; considering statistical significance at P < 0.05. Results:Of the 111 patients studied, 70 were men (63.1%) and 90 were white (81.1%), with a median age of 68 years. The MES frequency was 7%. There was a significant relationship between MES and symptomatic carotid disease (OR = 22.7; 95% CI 4.1-125.7; P < 0.001), a shorter time to monitoring (OR = 12.4; 95% CI 1.4-105.4; P = 0.02), and stroke recurrence (OR = 16.83; 95% CI 2.01-141; P = .009). Discussion:It was observed that the stroke recurrence adjusted for prior stroke was higher and earlier among patients with MES detection. In conclusion, MES demonstrated a significant correlation with symptomatic carotid disease and a shorter DELAY until monitoring, and could be a predictor for the early recurrence of stroke in the long term.

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Objective Rehabilitation top‐down techniques based on brain stimulation present variable outcomes in unilateral spatial neglect (USN) after stroke. This study aimed to examine the effects of physical therapy after anodal and cathodal transcranial direct current stimulation (A‐tDCS and C‐tDCS, respectively) to improve visuospatial and functional impairments in individuals with USN after stroke. Methods This double‐blinded, pilot randomized clinical trial enrolled patients with USN after ischemic stroke. Randomization was stratified according to the Behavior Inattention Test–Conventional (BIT‐C) and Catherine Bergego Scale (CBS). Outpatient physical therapy was conducted for 7.5 weeks after 20 minutes of tDCS. The primary outcome was the USN degree evaluated by the BIT‐C. Secondary outcomes were the difference in CBS score, stroke severity (National Institutes of Health Stroke Scale [NIHSS]), disability (modified Rankin Scale), autonomy (Barthel Index, Functional Independence Measure), and quality of life (EuroQol Group 5‐Dimension Self‐Report Questionnaire). Outcomes were analyzed using an analysis of covariance model corrected by age, baseline NIHSS, and baseline BIT‐C. Pairwise post hoc comparisons were performed using Bonferroni correction. Results In the primary outcomes, A‐tDCS led to greater improvement in BIT‐C after intervention (mean difference [MD] = 18.4, 95% confidence interval [CI] = 3.9–32.8, p = 0.008) compared to sham. However, no significant differences were observed between A‐tDCS and C‐tDCS (MD = 13.9, 95% CI = −0.3 to 28.1, p = 0.057), or C‐tDCS and sham (MD = 4.5, 95% CI = −9.7 to 18.8, p = 0.99). There were no significant differences between groups in terms of secondary outcomes. Interpretation A‐tDCS associated with physical therapy can decrease the severity of USN after stroke. However, these preliminary findings must be confirmed by collecting additional evidence in a larger phase 3 trial. ANN NEUROL 2022;92:400–410