Italian standardization of the Apples Cancellation Test

Mancuso, Mauro; Rosadoni, S.; Capitani, D.; Bickerton, Wai‐Ling; Humphreys, Glyn W.; Tanti, Antonio De; Zampolini, Mauro; Galardi, Giuseppe; Caputo, Marina; Pellegrin, Serena De; Angelini, Andrea; Bartalini, B.; Bartolo, Michelangelo; Carboncini, Maria Chiara; Gemignani, Paola; Spaccavento, Simona; Cantagallo, Anna; Zoccolotti, Pierluigi; Antonucci, Gabriella

doi:10.1007/s10072-015-2088-2

Cited by 43 publications

(39 citation statements)

References 20 publications

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“…Recently, a new cancellation test has been created: the Apples test [30,31]. This test enables the detection of both egocentric neglect (patients fail to find stimuli on the left side with respect to egocentric coordinates) and allocentric neglect (patients leave targets with respect to coordinates centered on the object, but independent of the side of space).…”

Section: Introductionmentioning

confidence: 99%

The assessment of hemineglect syndrome with cancellation tasks: a comparison between the Bells test and the Apples test

Basagni

Tanti

Damora³

et al. 2017

Neurol Sci

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Unilateral spatial neglect (USN) is a frequent consequence of acquired brain injury, especially following right hemisphere damage. Traditionally, unilateral spatial neglect is assessed with cancellation tests such as the Bells test. Recently, a new cancellation test, the Apples test, has been proposed. The present study aims at comparing the accuracy of these two tests in detecting hemispatial neglect, on a sample of 56 right hemisphere stroke patients with a diagnosis of USN. In order to evaluate the agreement between the Apples and Bells tests, Cohen's kappa and McNemar's test were used to assess differences between the two methods of evaluation. Poor agreement and statistically significant differences emerged between the Apples and Bells tests. Overall, the Apples test was significantly more sensitive than the Bells test in detecting USN. Based on these results, the use of the Apples test for peripersonal neglect assessment is therefore highly recommended.

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Section: Introductionmentioning

confidence: 99%

The assessment of hemineglect syndrome with cancellation tasks: a comparison between the Bells test and the Apples test

Basagni

Tanti

Damora³

et al. 2017

Neurol Sci

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“…The ischemic lesion extension was estimated according to the Alberta Stroke Program Early CT Score (ASPECTS) on head computed tomography (CT) performed in emergency prior to IVT administration 30 . Patients with a neurological or psychiatric history, pre-stroke modified Rankin Scale (mRS) 31 score > 2, patients who did not perform the neuropsychological evaluation at 6 months from stroke and those who presented aphasia or neglect at the 6-month evaluation according to the Aphasia Neuropsychological Exam (ANE) (language) 32 and Apples Cancellation Test (ACT) (visuo-spatial inattention) 33 were not included.…”

Section: Methodsmentioning

confidence: 99%

Endovascular treatment and cognitive outcome after anterior circulation ischemic stroke

Lattanzi

Coccia

Pulcini

et al. 2020

Sci Rep

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The impact of reperfusion therapies on cognition has been poorly explored and little knowledge exists. We explored the influence of endovascular treatment (EVT) on cognitive outcome in patients with anterior circulation ischemic stroke. Patients presenting with ischemic stroke due to anterior large vessel occlusion who underwent intravenous thrombolysis (IVT) alone or EVT plus IVT were recruited. Cognitive abilities were evaluated at 6 months from stroke through a neuropsychological test battery. A total of 88 patients with a mean age of 66.3 ± 12.9 years were included, of which 38 treated with IVT alone and 50 with IVT plus EVT. Compared to patients treated with IVT alone, patients who received EVT plus IVT performed significantly better at the neuropsychological tests exploring executive functions, attention, abstract reasoning, visuospatial ability, visual and verbal and memory. At multivariable regression analysis, the EVT was independently associated with the 6-month cognitive performance after the adjustment for age, sex, admission National Institutes of Health Stroke Scale score, systolic blood pressure, glucose level, Alberta Stroke Program Early CT score, side of stroke, site of occlusion, and Back Depression Inventory score [Stroop Test Word Reading: adjβ = 13.99, 95% confidence interval (CI) 8.47–19.50, p < 0.001; Stroop Test Colour Naming: adjβ = 6.63, 95% CI 2.46–10.81, p = 0.002; Trail Making Test-A: adjβ = − 92.98, 95% CI − 153.76 to − 32.20, p = 0.003; Trail Making Test-B: adjβ = − 181.12, 95% CI − 266.09 to − 96.15; p < 0.001; Digit Span Test Forward: adjβ = 1.44, 95% CI 0.77–2.10, p < 0.001; Digit Span Test Backward: adjβ = 1.10, 95% CI 0.42–1.77, p = 0.002; Coloured Progressive Matrices: adjβ = 5.82, 95% CI 2.71–8.93, p < 0.001; Rey Complex Figure Test-Copy: adjβ = 6.02, 95% CI 2.74–9.30, p < 0.001; Rey Complex Figure Test-Immediate recall: adjβ = 6.00, 95% CI 2.34–9.66, p = 0.002; Rey Complex Figure Test-Delayed recall: adjβ = 5.73, 95% CI 1.95–9.51, p = 0.003; Rey Auditory Verbal Learning Test-Immediate recall: adjβ = 12.60, 95% CI 6.69–18.52, p < 0.001; Rey Auditory Verbal Learning Test-Delayed recall: adjβ = 1.85, 95% CI 0.24–3.45, p = 0.025]. Patients treated with EVT plus IVT had better cognitive performance than patients treated with IVT alone at 6 months from anterior circulation ischemic stroke.

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“…That test consisted of 150 apple-shaped images (50 target images [full apples] and 100 distractor images [left or right open apple]) on A4 paper. [ 18 , 23 ] The test page was divided into 5 areas (2 left, 1 middle, and 2 right areas) by an invisible grid and 150 apple images were pseudorandomly scattered over the page (30 apples per area). Test scoring for egocentric neglect was based on the difference between the numbers of right area and left area (excluding the middle area), whereas scoring for allocentric neglect was based on the difference between the numbers of left area and right area open apples (including those in the middle area).…”

Section: Case Reportmentioning

confidence: 99%

“…The cutoff scores for the presence of left side neglect by neglect type were: egocentric neglect >2, allocentric neglect >1 (a minus score indicates right side neglect). [ 18 ] The Apple Cancellation test has been validated for clinical usefulness via the Star Cancellation test [ 18 ] and recently standardized for both English [ 24 ] and Italian [ 23 ] populations.…”

Section: Case Reportmentioning

confidence: 99%

The different association of allocentric and egocentric neglect with dorsal and ventral pathways

Jang

2018

Medicine

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Rationale:Egocentric neglect is characterized by responses missing on the contralateral side with respect to the viewer, while allocentric neglect is characterized in responses missing on the contralateral side with respect to the object . However, little has been reported about the neural tracts associated with egocentric and allocentric neglect. We investigated which neural tracts were involved in two types of neglect (egocentric and allocentric) in a stroke patient who showed allocentric neglect by using the Apple Cancellation test, a specialized test to distinguish between egocentric and allocentric neglect.Patient concerns:He showed good cognitive function but presented with severe neglect on the left side (A 42-year-old, right-handed male patient). He was unable to undergo even the pencil and paper test for evaluation of the severity of neglect.Diagnoses:He was diagnosed as spontaneous intracerebral hemorrhage at the right basal ganglia and underwent conservative management at the neurosurgery department of a university hospital.Interventions:Two weeks after onset, he began rehabilitation at the rehabilitation department of the same university hospital. During a seven month rehabilitation, the patient showed significant improvement of his severe left neglect.Outcomes:We used the Apple Cancellation test to distinguish between egocentric and allocentric neglect; the results failed to reveal egocentric neglect, however, they did reveal severe allocentric neglect. In addition, on diffusion tensor tractography (DTT) at 2 weeks after onset, the right superior longitudinal fasciculus (SLF) showed partial injury and narrowing in the parietal lobe compared to that of the left SLF. In addition, the right inferior fronto-occipital fasciculus (IFOF) was not reconstructed. By contrast, on 7-month post-onset DTT, the right SLF revealed elongation and thickening in the parietal lobe that approached similarity to that for the left SLF. However, the right IFOF was still not reconstructed.Lessons:The associations of egocentric neglect with the dorsal pathway (SLF) and the association of allocentric neglect with the ventral pathway (IFOF) in the right hemisphere were demonstrated in a stroke patient. It appears that DTT can be helpful in demonstrating both the affected pathway and the neglect type in patients with neglect.

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Italian standardization of the Apples Cancellation Test

Cited by 43 publications

References 20 publications

The assessment of hemineglect syndrome with cancellation tasks: a comparison between the Bells test and the Apples test

The assessment of hemineglect syndrome with cancellation tasks: a comparison between the Bells test and the Apples test

Endovascular treatment and cognitive outcome after anterior circulation ischemic stroke

The different association of allocentric and egocentric neglect with dorsal and ventral pathways

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