A Circle-Monitor for Computerised Assessment of Visual Neglect in Peripersonal Space

Abstract

Current assessment of visual neglect involves paper-and-pencil tests or computer-based tasks. Both have been criticised because of their lack of ecological validity as target stimuli can only be presented in a restricted visual range. This study examined the user-friendliness and diagnostic strength of a new “Circle-Monitor” (CM), which enlarges the range of the peripersonal space, in comparison to a standard paper-and-pencil test (Neglect-Test, NET).MethodsTen stroke patients with neglect and ten age-matched healthy controls were examined by the NET and the CM test comprising of four subtests (Star Cancellation, Line Bisection, Dice Task, and Puzzle Test).ResultsThe acceptance of the CM in elderly controls and neglect patients was high. Participants rated the examination by CM as clear, safe and more enjoyable than NET. Healthy controls performed at ceiling on all subtests, without any systematic differences between the visual fields. Both NET and CM revealed significant differences between controls and patients in Line Bisection, Star Cancellation and visuo-constructive tasks (NET: Figure Copying, CM: Puzzle Test). Discriminant analyses revealed cross-validated assignment of patients and controls to groups was more precise when based on the CM (hit rate 90%) as compared to the NET (hit rate 70%).ConclusionThe CM proved to be a sensitive novel tool to diagnose visual neglect symptoms quickly and accurately with superior diagnostic validity compared to a standard neglect test while being well accepted by patients. Due to its upgradable functions the system may also be a valuable tool not only to test for non-visual neglect symptoms, but also to provide treatment and assess its outcome.

A Meta-Analysis of Line Bisection and Landmark Task Performance in Older Adults

“…LM also tested but baseline mean and SD not reported. 54 Ulm et al ( 2013 ) 68.0 10 LB Y (neglect) -0.5 A,H, S 2 - 55 Vallar et al ( 2000 ) 62.7 6 LB Y (neglect) 0.2 A, H, LL Mean and SD obtained from authors (baseline condition without fins ) for 3 line lengths. d calculated separately for each, then averaged.…”

Computer-Based Assessment: Dual-Task Outperforms Large-Screen Cancellation Task in Detecting Contralesional Omissions

“…As the attention deficits were only subtle, and the sample size was limited, additional studies are needed to confirm the present results. Additional studies would also be needed to answer pertinent questions related to the new cancellation task: (1) was the Twinkle Task in itself sensitive and a useful screening task for clear neglect in the acute phase of stroke; (2) could it, much like some other "gap-detection" tasks (e.g., Ota et al, 2001), be useful in differentiating between body-centered and stimulus-centered neglect; and (3) could the scanning pattern recordings enabled by the large-screen version provide insights into the abnormal scanning latency and crossing index, which are typical for neglect patients (Rabuffetti et al, 2002;Ulm et al, 2013)?…”

“…However, computerbased applications have been criticized for introducing stimuli that subtend a limited visual angle. It has been claimed that tasks presented on a standard computer screen or on a sheet of paper may have poor ecological validity (Nakatani et al, 2013;Ulm et al, 2013). Advantages of assessment methods with large perceptual space have been described in studies using dual-tasks (van Kessel et al, 2013;Villarreal et al, 2020) and cancellation tasks (Tanaka et al, 2005;Tsirlin et al, 2009;Ulm et al, 2013;Knobel et al, 2020).…”

“…It has been claimed that tasks presented on a standard computer screen or on a sheet of paper may have poor ecological validity (Nakatani et al, 2013;Ulm et al, 2013). Advantages of assessment methods with large perceptual space have been described in studies using dual-tasks (van Kessel et al, 2013;Villarreal et al, 2020) and cancellation tasks (Tanaka et al, 2005;Tsirlin et al, 2009;Ulm et al, 2013;Knobel et al, 2020). Both the large-screen dual-tasks and the large-screen cancellation tasks appear to be more sensitive in revealing spatial bias than paper-and-pencil cancellation tasks (Ulm et al, 2013;van Kessel et al, 2013;Villarreal et al, 2020).…”

“…Past studies have highlighted the important role of unspecific attentional demands (Dawson et al, 2008;Bonato et al, 2010Bonato et al, , 2012Buxbaum et al, 2012;Blini et al, 2016;Ricci et al, 2016;Andres et al, 2019), large test fields (Nakatani et al, 2013;Ulm et al, 2013), or both (Villarreal et al, 2020) in determining the sensitivity of tests for neglect and extinction. In the present study, we aimed to capitalize on the previous findings by contrasting these two characteristics.…”