Occurrence and Recovery of Different Neglect-Related Symptoms in Right Hemisphere Infarct Patients during a 1-Year Follow-Up

Nurmi, Laura; Ruuskanen, Eija-Inkeri; Nurmi, Mari; Koivisto, Anna‐Maija; Parkkila, Anna‐Kaisa; Numminen, Heikki; Dastidar, Prasun; Jehkonen, Mervi

doi:10.1017/s1355617718000176

Cited by 9 publications

(10 citation statements)

References 54 publications

(156 reference statements)

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“…RH patients did not show spatial bias in either version of the Twinkle Task, even though the increase in the visual angle was massive and performance was analyzed with multiple parameters in addition to omissions. Unlike in previous studies (Azouvi et al, 2002;Nurmi et al, 2010Nurmi et al, , 2018Basagni et al, 2017;Priftis et al, 2019), analyzing starting points, increasing perceptual demands, or limiting performance time had no sensitivity increment effect in detecting spatial bias in the group of RH patients. Standard, paper-and-pencil approaches are maximally informative in acute stroke, and with rather severe cases.…”

Section: Discussioncontrasting

confidence: 85%

“…To prevent compensation and to identify milder deficits, time limits are sometimes introduced (Priftis et al, 2019). Another possibility is to calculate indices that are more sophisticated than the simple number of omissions, such as the starting point analysis (Azouvi et al, 2002;Nurmi et al, 2010Nurmi et al, , 2018, which allows quantifying neglect patients' tendency to start visual searching from the ipsilesional hemispace (Kinsbourne, 1987;Karnath, 1988;Olk et al, 2002). Despite these efforts, several studies have demonstrated that computer tasks, which are complex, and require high attentional demands, are more sensitive than paper-and-pencil cancellation tasks (Deouell et al, 2005;List et al, 2008;Rengachary et al, 2009;Bonato et al, 2010Bonato et al, , 2012Blini et al, 2016;Andres et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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Objective: Traditionally, asymmetric spatial processing (i.e., hemispatial neglect) has been assessed with paper-and-pencil tasks, but growing evidence indicates that computer-based methods are a more sensitive assessment modality. It is not known, however, whether simply converting well-established paper-and-pencil methods into a digital format is the best option. The aim of the present study was to compare sensitivity in detecting contralesional omissions of two different computer-based methods: a “digitally converted” cancellation task was compared with a computer-based Visual and Auditory dual-tasking approach, which has already proved to be very sensitive.Methods: Participants included 40 patients with chronic unilateral stroke in either the right hemisphere (RH patients, N = 20) or the left hemisphere (LH patients, N = 20) and 20 age-matched healthy controls. The cancellation task was implemented on a very large format (173 cm × 277 cm) or in a smaller (A4) paper-and-pencil version. The computer-based dual-tasks were implemented on a 15′′ monitor and required the detection of unilateral and bilateral briefly presented lateralized targets.Results: Neither version of the cancellation task was able to show spatial bias in RH patients. In contrast, in the Visual dual-task RH patients missed significantly more left-sided targets than controls in both unilateral and bilateral trials. They also missed significantly more left-sided than right-sided targets only in the bilateral trials of the Auditory dual-task.Conclusion: The dual-task setting outperforms the cancellation task approach even when the latter is implemented on a (large) screen. Attentionally demanding methods are useful for revealing mild forms of contralesional visuospatial deficits.

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Section: Discussioncontrasting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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“…Chronic patients often manifest such persisting attention deficits that affect both sides of space (Corbetta & Shulman, 2011;Husain & Rorden, 2003;Manly, 2002;Robertson, 1993; van Kessel, van Nes, Brouwer, Geurts, & Fasotti, 2010), and complain about severe and long-lasting impairment in the ability to maintain concentration when reading, following TV programmes, or engaging in other prolonged activities such as therapy sessions. In a recent study by Nurmi and colleagues (Nurmi et al, 2018), the researchers followed patients with mild neglect in their first year after stroke and observed a longitudinal reduction in spatial bias as measured on cancellation tasks, with omissions becoming evenly distributed in space -a pattern which indicates persisting non-lateralised deficits, rather than ongoing pathological lateralised bias. This is also reflected in our clinical experience working with patients affected by severe neglect at presentation, who often demonstrate a non-lateralised pattern of omissions when re-tested in later stages post-stroke (Figure 2).…”

Section: Non-lateralised Deficits In Neglectmentioning

confidence: 99%

Using non-invasive transcranial direct current stimulation for neglect and associated attentional deficits following stroke

Olgiati

Malhotra

2020

Neuropsychological Rehabilitation

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Neglect is a disabling neuropsychological syndrome that is frequently observed following right-hemispheric stroke. Affected individuals often present with multiple attentional deficits, ranging from reduced orienting towards contralesional space to a generalised impairment in maintaining attention over time. Although a degree of spontaneous recovery occurs in most patients, in some individuals this condition can be treatment-resistant with non-spatial deficits being particularly persistent. Moreover, there is a large inter-individual variability in response to different therapeutic approaches. Given its potential to alter neuronal excitability and affect neuroplasticity, non-invasive brain stimulation is a promising tool that could potentially be utilised to facilitate recovery. However, there are many outstanding questions regarding its implementation in this heterogeneous patient group.Here we provide a critical overview of the available evidence on the use of non-invasive electrical brain stimulation, with a focus on transcranial direct current stimulation (tDCS), to improve neglect and associated attentional deficits after right-hemispheric stroke. At present, there is not enough robust evidence supporting the clinical use of tDCS to alleviate symptoms of neglect. Future research would benefit from careful study design, enhanced precision of electrical montages, multi-modal approaches that explore predictors of response, tailored dose-control applications and increased efforts to understand the potential of tDCS, as a stand-alone technique and in synergy with other available treatments for neglect.1 The Neglect syndrome Attention deficits represent the most common cognitive sequelae following right-hemispheric stroke . The neglect syndrome is an heterogenous condition, currently considered a multi-component syndrome (

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“…However, an association between slowed processing speed and neglect was reported in a longitudinal study up to one year after stroke. 28 In that study, right hemispheric stroke patients with acute neglect or milder forms of left-sided inattention showed a significantly slower processing speed in the acute phase, at 6 months, and at 12 months after stroke compared to healthy controls. The association between long-term lateralized inattention and early processing speed is interesting since previous stroke studies have suggested that decreased speed appears to underlie cognitive dysfunction in different domains such as visuoperceptual function and executive function.…”

Section: Discussionmentioning

confidence: 79%

“…To our knowledge, an association between processing speed at the early phase after stroke and occurrence of long‐term neglect or lateralized inattention has not been previously investigated. However, an association between slowed processing speed and neglect was reported in a longitudinal study up to one year after stroke . In that study, right hemispheric stroke patients with acute neglect or milder forms of left‐sided inattention showed a significantly slower processing speed in the acute phase, at 6 months, and at 12 months after stroke compared to healthy controls.…”

Section: Discussionmentioning

confidence: 89%

The presence and prediction of lateralized inattention 7 years post‐stroke

et al. 2020

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Objective Lateralized inattention is a typical sign of neglect and related to poor functional outcome. Knowledge of the long‐term course of this phenomenon is limited. The purpose of this study was to investigate presence and predictors for signs of lateralized inattention 7 years after stroke. Methods From a cohort of acute ischemic stroke patients, aged 18‐69 years (n = 297), a consecutive series of 188 survivors without recurrent stroke at follow‐up 7 years later were included. Within the first week after stroke onset, stroke severity was assessed according to the Scandinavian Stroke Scale. Target omissions, asymmetry of omissions, and perceptual speed according to Star‐ and Letter Cancellation Tests were also assessed. Presence of lateralized inattention at the 7‐year follow‐up was investigated with the Star‐ and Letter Cancellation Tests and with the neglect item in the National Institutes of Health Stroke Scale. Results At the follow‐up, 22 (11.7%) participants had lateralized inattention and the multivariable regression showed that independent significant baseline predictors were total omissions in target cancellations (P < .001) and inferior baseline performance on visual processing speed (P = .008). Conclusion About one of ten individuals exhibited signs of lateralized inattention 7 years after stroke. Baseline performance in perceptual processing speed and target omissions independently predicted presence of late signs of lateralized inattention. This is the first time processing speed is recognized as a significant predictor of lateralized inattention several years after the stroke incidence, indicating that the longitudinal course of processing speed following stroke is a critical subject for future research.

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Occurrence and Recovery of Different Neglect-Related Symptoms in Right Hemisphere Infarct Patients during a 1-Year Follow-Up

Cited by 9 publications

References 54 publications

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

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

Using non-invasive transcranial direct current stimulation for neglect and associated attentional deficits following stroke

The presence and prediction of lateralized inattention 7 years post‐stroke

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