Measuring visual neglect in acute stroke and predicting its recovery: the visual neglect recovery index.

Abstract

An overall measure of the recovery of visual neglect in patients with an acute stroke is described: The "Visual Neglect Recovery Index" (VNRI) expresses the amount of visual neglect on a battery of visual neglect tests as a percentage of complete recovery from the maximal visual neglect measurable. The principles underlying the development of the index are similar to those involved in the development of the Motricity Index for hemiplegia. A population of 68 survivors of stroke who presented with visual neglect at two to three days were followed for up to six months. The VNRI showed that neglect was greater in those with right hemisphere stroke than in those with left hemisphere stroke and that recovery was most rapid over the first 10 days and reached a plateau at three months. Most patients, including many with severe initial visual neglect, showed little visual neglect at three months. Stepwise regression analysis showed that the severity of visual neglect at three months and at six months post-stroke could be predicted by the severity of visual neglect and the presence of anosognosia at two to three days. A regression equation was produced which may enable clinicians to select patients for intensive treatment of visual neglect.

Inconsistency of performance on neglect subtype tests following acute right hemisphere stroke

“…The cut-off score for line bisection was determined by scoring guidelines provided for the Behavioral Inattention Test (Wilson et al, 1987). Using this definition neglect was present in nearly 50% of the right hemisphere stroke patients studied previously by Buxbaum et al (2004), which was consistent with previous reports of neglect prevalence (Stone et al, 1992).…”

Disentangling the Neuroanatomical Correlates of Perseveration from Unilateral Spatial Neglect

“…Not all investigators have found high perseveration rates following left hemisphere damage [6]. Second, we did not calculate an index of neglect severity as in some recent studies [37,38]. Although we feel the absolute number of neglect responses is an appropriate measure and the data is clear (Fig.…”

Cognitive Rehabilitation Interventions for Neglect and Related Disorders: Moving from Bench to Bedside in Stroke Patients

“…Neglect is a common consequence of right-hemisphere stroke. Its reported incidence ranges from 13% (Stone, Patel, Greenwood, & Halligan, 1992) to 81% of patients with right-hemisphere stroke (Sunderland, Wade, & Langton Hewer, 1987), presumably reflecting differences in subject inclusion criteria, lesion location, and assessment procedures (see Bowen, McKenna, & Tallis, 1999); a number of recent studies indicate that about 50% of patients exhibit the disorder (Buxbaum, Ferraro, Veramonti, et al, 2004;Mapstone et al, 2003). Neglect may also be observed in patients with left-hemisphere stroke, but it is more common and more severe in association with right-hemisphere lesions (Ringman, Saver, Woolson, Clarke, & Adams, 2004;Gainotti, 1972).…”